Sepsis-induced Pancytopenia in an Adolescent Girl with Thyroid Storm: A Case Report

• Main Authors: Qing Zhou (Author), Li-Yong Zhang (Author), Qing-Xian Fu (Author), Chao-Chun Zou (Author), Hui Liu (Author)
• Format: Book
• Published: Galenos Yayincilik, 2024-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.4274/jcrpe.galenos.2023.2022-10-3; 1308-5727; 1308-5735
• Keywords: thyroid storm; pancytopenia; sepsis; antithyroid drugs; Pediatrics; RJ1-570; Diseases of the endocrine glands. Clinical endocrinology; RC648-665
• Source: JCRPE, Vol 16, Iss 3, Pp 367-371 (2024)

Thyroid storm is a rare but life-threatening condition mainly triggered by infection and abrupt discontinuation of antithyroid drug therapy for Graves' disease. Pancytopenia is a rare adverse reaction to antithyroid drugs. We present a 13-year-old girl with thyroid storm and pancytopenia with symptoms similar to those of methimazole-induced pancytopenia. Although in this context the use of methimazole is still under debate, due to multiple normal complete blood counts (CBC) monitored during fever, sepsis-induced pancytopenia with thyroid storm was considered, and methimazole treatment combined with methylprednisolone and meropenem was able to resolve both pancytopenia and thyroid storm. During the period of infection and antithyroid drug therapy, close monitoring of CBC may help differentiate the aetiology of pancytopenia. This is the first paediatric case report that outlines the use of methimazole in the management of thyroid storm with pancytopenia.