Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access
Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc
Journal website http://www.jofem.org

Case Report

Volume 6, Number 2, April 2016, pages 59-63


A Case of Thyroid Crisis With Worsening Jaundice Despite Improvements in Heart Failure

Figures

Figure 1.
Figure 1. (a) Chest X-ray and (b) electrocardiogram on admission.
Figure 2.
Figure 2. Clinical course of the patient.

Table

Table 1. Laboratory Findings on Admission
 
TgAb: anti-thyroglobulin antibody; TPOAb: anti-thyroid peroxidase antibody; TRAb: TSH receptor antibody; TSAb: thyroid-stimulating antibody; Fib: fibrinogen.
Urinalysis
  Protein2+
  Glucose-
  Ketone bodies-
  Bilirubin1+
Blood cell count
  WBC4,500/μL
  RBC352 × 104/μL
  Hb9.7 g/dL
  Plt10.6 × 104/μL
Serological test
  CRP0.41 mg/dL
  HBs Ag-
  HCV Ab-
Blood chemistry
  T-bil4.9 mg/dL
  AST32 U/L
  ALT23 U/L
  LDH245 U/L
  ALP779 U/L
  γ-GTP54 U/L
  CK95 U/L
  T-cho78 mg/dL
  TG37 mg/dL
  TP7.5 g/dL
  Alb2.3 g/dL
  BUN13.7 mg/dL
  Cr0.35 mg/dL
  Na138 mEq/L
  K4.2 mEq/L
  Cl105 mEq/L
  Glucose104 mg/dL
  HbA1c5.2%
Endocrine examination
  Free T317.2 pg/mL
  Free T47.0 ng/dL
  TSH0.003 μIU/mL
  TSAb330%
  TRAb7.1 IU/L
  TPOAb180 IU/mL
  TgAb104 IU/mL
  ACTH254 pg/mL
  Cortisol17.7 μg/dL
  BNP836 pg/mL
Hemostatic test
  PT> 120 s
  PT%< 5.0%
  Fib107 mg/dL
  ATIII22.3%
  FDP12.3 μg/mL
  D-dimer4.8 μg/mL