Rare Presentation of Thyrotoxicosis Defying Methimazole Treatment: A Case Series

Thyrotoxicosis, also known as hyperthyroidism, is a condition characterized by the excessive production of thyroid hormones by the thyroid gland. Besides Graves' disease, other common causes of thyrotoxicosis include toxic multinodular goiter, toxic adenoma, and subacute thyroiditis. The treatm...

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Published inCurēus (Palo Alto, CA) Vol. 16; no. 4; p. e58980
Main Authors Renzu, Mahvish, Mehta, Vidhi, Qazi, Adam, Satei, Alexander M, Taha, Wael
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 25.04.2024
Subjects
Ablation
Biopsy
Case reports
Drug dosages
Drug resistance
Hormone replacement therapy
Hyperthyroidism
Iodine
Parkinson's disease
Patients
Thyroid diseases
Thyroidectomy
Ultrasonic imaging
methimazole resistance
hyperthyroidism
antithyroid medication resistance
antithyroid medications
thyrotoxicosis
treatment of hyperthyroidism
management of thyrotoxicosis
methimazole
endocrine disorders
graves’s diseases
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Summary:Thyrotoxicosis, also known as hyperthyroidism, is a condition characterized by the excessive production of thyroid hormones by the thyroid gland. Besides Graves' disease, other common causes of thyrotoxicosis include toxic multinodular goiter, toxic adenoma, and subacute thyroiditis. The treatment of thyrotoxicosis depends on the underlying cause and may include medications (e.g., antithyroid drugs, beta-blockers), radioactive iodine therapy, or surgical removal of the thyroid gland (thyroidectomy). In this report, we present two instances of thyrotoxicosis where conventional high doses of antithyroid treatment failed to control the condition effectively. This failure prompted the exploration of alternative therapeutic interventions. These cases highlight the intricacies involved in managing thyrotoxic crises that do not respond to methimazole (MMI), emphasizing the necessity for innovative approaches such as plasmapheresis and thyroidectomy. Understanding such scenarios is vital for enhancing the care provided to patients encountering resistance to standard treatments. The distinct clinical pathways and treatment strategies adopted in these cases offer valuable insights into this disease management, particularly concerning resistance to MMI.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.58980