Kim HE, Yang J, Park JE, Baek JC, Jo HC. Thyroid storm in a pregnant woman with COVID-19 infection: A case report and review of literatures. World J Clin Cases 2023; 11(4): 888-895 [PMID: 36818620 DOI: 10.12998/wjcc.v11.i4.888]
Corresponding Author of This Article
Hyen-Chul Jo, MD, PhD, Assistant Professor, Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Samjunga Street 11, Sungsan Gu, Changwon 51472, South Korea. cholida73@naver.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Feb 6, 2023; 11(4): 888-895 Published online Feb 6, 2023. doi: 10.12998/wjcc.v11.i4.888
Thyroid storm in a pregnant woman with COVID-19 infection: A case report and review of literatures
Hyo-Eun Kim, Juseok Yang, Ji-Eun Park, Jong-Chul Baek, Hyen-Chul Jo
Hyo-Eun Kim, Juseok Yang, Ji-Eun Park, Jong-Chul Baek, Hyen-Chul Jo, Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Changwon 51472, South Korea
Author contributions: Jo HC suggested the initial idea and designed this study; Yang J, Park JE, and Baek JC collected the relevant data; Kim HE analyzed the data and prepared the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised accordingly.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hyen-Chul Jo, MD, PhD, Assistant Professor, Department of Obstetrics and Gynecology, Gyeongsang National University Changwon Hospital, Samjunga Street 11, Sungsan Gu, Changwon 51472, South Korea. cholida73@naver.com
Received: October 27, 2022 Peer-review started: October 27, 2022 First decision: November 11, 2022 Revised: November 24, 2022 Accepted: January 5, 2023 Article in press: January 5, 2023 Published online: February 6, 2023 Processing time: 102 Days and 1.9 Hours
Abstract
BACKGROUND
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been found to be responsible for the recent global pandemic known as coronavirus disease 2019 (COVID-19). SARS-CoV-2 infections not only result in significant respiratory symptoms but also cause several extrapulmonary manifestations, such as thrombotic complications, myocardial dysfunction and arrhythmia, thyroid dysfunction, acute kidney injury, gastrointestinal symptoms, neurological symptoms, ocular symptoms, and dermatological complications. We present the first documented case of thyroid storm in a pregnant woman precipitated by SARS-CoV-2.
CASE SUMMARY
A 42-year-old multiparous woman at 35 + 2 wk of gestation visited the emergency room (ER) with altered mentation, seizures, tachycardia, and high fever. The patient showed no remarkable events in the prenatal examination, and the nasopharyngeal COVID-19 polymerase chain reaction (PCR) test was positive two days before the ER visit. The results of laboratory tests, such as liver function test, serum electrolytes, blood glucose, blood urea nitrogen, and creatinine, were all within the normal ranges. However, the thyroid function test showed hyperthyroidism, and the nasopharyngeal COVID-19 PCR test was positive, as expected. No specific findings were observed on the brain computed tomography, and there were no signs of lateralization on neurological examination. Fetal heartbeat and movement were good, and there were no significant uterine contractions. The initial impression was atypical eclampsia. However, the patient's condition worsened, and a cesarean section was performed under general anesthesia; a healthy boy was delivered, and 12 h after delivery, the patient's seizures disappeared and consciousness was restored. The patient was referred to an endocrinologist for hyperthyroidism, and a thyroid storm with Graves' disease was diagnosed. Here, SARS-CoV-2 was believed to be the trigger for the thyroid storm, considering that the patient tested positive for COVID-19 two days before the seizures.
CONCLUSION
In pregnant women presenting with seizures or changes in consciousness, the possibility of a thyroid storm should be considered. There are various causes for a thyroid storm, but given the recent pandemic, it is necessary to bear in mind that the thyroid storm may be precipitated by COVID-19.
Core Tip: Coronavirus disease 2019 (COVID-19) is a pandemic disease. For pregnant women presenting with emergency symptoms, clinicians should consider the possibility of a thyroid storm caused by COVID-19.
