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Category: Volume 07 Issue 05 May 2019
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Title: Therapeutic Plasma Exchange in the management of Impending Thyroid Storm: Experience from Bangladesh

Authors: Dr Md. Ashraful Hoque, Dr Sheikh Saiful Islam, Prof. Md. Farid Uddin

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.127

Abstract

Inappropriately treated impending thyroid storm can cause death to a patient. Therapeutic plasma exchange (TPE) is a good option to reverse this condition and help in the proper handling of the patient, though its indication not clearly defined. In this case report we share our experience of one case who was admitted in the department of endocrinology of BSMMU. The patients was diagnosed as a case of impending thyroid storm in which radio-iodine therapy could not be started as because of very poor clinical and laboratory report. Therapeutic plasma exchange was given in two sessions in one day interval by experienced medical staff and no complications.  Main action of TPE is to remove the circulating putative antibodies, cytokines and thyroid hormones with their bound proteins. TPE has a brief effect and for this reason it   should be connected with remaining thyroid blockers. When threatening symptoms arise TPE should be given as early as possible without hesitation and should not wait for effect of conventional treatment as because it rapidly improves the clinical conditions. We are also suggested to start TPE in a case of impending thyroid storm as because our study has proven the efficacy of TPE in the management of impending thyroid storm.

Keywords: Endocrinology, Plasma exchange, Thyroid storm, RPM, Plasmapheresis.

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Corresponding Author

Dr Md. Ashraful Hoque

CMBT, MIS, DGHS