Authors:
Yudith Annisa Ayu Reskitha
;
Rio Wironegoro
;
Hermawan Susanto
;
Soebagijo Adi
and
Ari Sutjahjo
Affiliation:
Department of Internal Medicine, Faculty of medicine Universitas Airlangga, Dr. Soetomo General Hospital and Surabaya, Indonesia
Keyword(s):
Hyperosmolar hyperglycemic state, hyperthyroid, thyroid crisis, insulin
Abstract:
Hyperthyroidism is one form of thyrotoxicosis caused by excess synthesis and thyroid hormone secretion by the thyroid gland. Thyroid crisis is a life-threatening hyperthyroid exacerbation, characterized by decompensation of one or more organ systems and hyperosmolar hyperglycemic state (HHS) characterized by hyperglycemia, hyperosmolality, and dehydration without ketoacidosis. Cases of thyroid and HHS crises are rarely found in hyperthyroid patients. The purpose of this case report is to describe symptoms for diagnosis, therapy, and prognosis of hyperthyroid patients with thyroid and HHS crises. We reviewed the literature and describe hyperthyroid manifestations with thyroid crisis and HHS. A 30-year-old woman found an increase in pulse rate, body temperature, respiration rate, enlarged diffuse solid (50 cm3), mobile, dry skin, 600 cc / 4-hour urine production, Burch-Wartofsky score of 95, elevated blood glucose, and osmolarity blood. Therapies were given under the formula TS 416688-
24-6 for thyroid crisis, rehydration, and management of blood sugar levels was used for HHS. The patient showed improvement after five days of care with a good prognosis. It was concluded that thyroid crisis and HHS have a poor prognosis because of the high mortality rates. Identification and the correct diagnosis could improve the prognosis of the case.
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