Skip to main content Skip to main navigation menu Skip to site footer

Problem diagnostik dan tatalaksana terkini krisis tiroid: sebuah laporan kasus

  • Ni Made Savitri Devi ,
  • Made Ratna Saraswati ,

Abstract

Background: Graves’ disease is a systemic autoimmune disorder, characterized by the production of thyroid-stimulating IgG immunoglobulins (TSI) directed towards the thyroid-stimulating hormone (TSH) receptor of the thyroid-hormone producing cell. Graves’ disease is known to be the most common cause of thyroid crisis. Thyroid crisis is one of the first levels of emergency in the endocrine field with very high morbidity and mortality.

Case presentation: A 41-year-old man presents with the chief complaint of severe tightness and swelling throughout the body, the patient is diagnosed with thyroid crisis caused by Graves’ disease and acute decompensated heart failure suspected caused by coronary artery disease differential diagnosed with tachycardia induced cardiomyopathy. The patient has a history of previous hospitalization with the same complaint, at that time the patient was only diagnosed with congestive heart failure suspected caused by coronary artery disease.

Conclusion: Late diagnosis will hinder the proper administration of treatment to the patient. here in the case of emergencies an earlier diagnosis is needed so that it can improve the quality of life of patients minimize the occurrence of potential complications.

 

Latar Belakang: Penyakit Graves merupakan kelainan autoimun sistemik yang ditandai dengan produksi imunoglobulin IgG perangsang tiroid (TSI) yang diarahkan ke reseptor hormon perangsang tiroid (TSH) pada sel penghasil hormon tiroid. Penyakit Graves diketahui sebagai penyebab paling umum dari krisis tiroid. Krisis tiroid merupakan salah satu keadaan darurat tingkat pertama di bidang endokrin dengan angka kesakitan dan kematian yang sangat tinggi.

Presentasi kasus: Seorang pria berusia 41 tahun datang dengan keluhan utama rasa sesak dan bengkak di sekujur tubuh, pasien didiagnosis menderita krisis tiroid yang disebabkan oleh penyakit Graves dan gagal jantung dekompensasi akut yang diduga disebabkan oleh penyakit arteri koroner diferensial didiagnosis dengan kardiomiopati akibat takikardia. Pasien mempunyai riwayat rawat inap sebelumnya dengan keluhan yang sama, saat itu pasien hanya didiagnosis menderita gagal jantung kongestif yang diduga disebabkan oleh penyakit arteri koroner.

Kesimpulan: Keterlambatan diagnosis akan menghambat pemberian pengobatan yang tepat pada pasien. disini dalam keadaan darurat diperlukan diagnosis dini sehingga dapat meningkatkan kualitas hidup pasien meminimalisir terjadinya potensi komplikasi.

References

  1. Idrose AM. Acute and emergency care for thyrotoxicosis and thyroid storm. Acute Med Surg. 2015;2(3):147-157. doi:10.1002/ams2.104
  2. Carroll R, Matfin G. Review: Endocrine and metabolic emergencies: thyroid storm. Ther Adv Endocrinol Metab. 2010;1(3):139-145. doi:10.1177/2042018810382481
  3. Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993;22(2):263-277.
  4. Pokhrel B, Aiman W, Bhusal K. Thyroid Storm. In: StatPearls. StatPearls Publishing; 2023. Accessed October 9, 2023. http://www.ncbi.nlm.nih.gov/books/NBK448095/
  5. Campi I, Salvi M. Graves’ Disease. In: Encyclopedia of Endocrine Diseases. Elsevier; 2018:698-701. doi:10.1016/B978-0-12-801238-3.98495-2
  6. Satoh T, Isozaki O, Suzuki A, et al. 2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition). Endocr J. 2016;63(12):1025-1064. doi:10.1507/endocrj.EJ16-0336
  7. Bahn Chair RS, Burch HB, Cooper DS, et al. Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists. Thyroid Off J Am Thyroid Assoc. 2011;21(6):593-646. doi:10.1089/thy.2010.0417
  8. Jameson JL, Mandel SJ, Weetman AP. Hyperthyroidism and Other Causes of Thyrotoxicosis. In: Loscalzo J, Fauci A, Kasper D, Hauser S, Longo D, Jameson JL, eds. Harrison’s Principles of Internal Medicine, 21e. McGraw-Hill Education; 2022. Accessed October 9, 2023. accessmedicine.mhmedical.com/content.aspx?aid=1198715617
  9. Okamura K, Sato K, Fujikawa M, Bandai S, Ikenoue H, Kitazono T. Remission after potassium iodide therapy in patients with Graves’ hyperthyroidism exhibiting thionamide-associated side effects. J Clin Endocrinol Metab. 2014;99(11):3995-4002. doi:10.1210/jc.2013-4466
  10. Kahaly GJ, Bartalena L, Hegedüs L, Leenhardt L, Poppe K, Pearce SH. 2018 European Thyroid Association Guideline for the Management of Graves’ Hyperthyroidism. Eur Thyroid J. 2018;7(4):167-186. doi:10.1159/000490384

How to Cite

Devi, N. M. S., & Saraswati, M. R. (2023). Problem diagnostik dan tatalaksana terkini krisis tiroid: sebuah laporan kasus. Intisari Sains Medis, 14(3), 1069–1074. https://doi.org/10.15562/ism.v14i3.1800

HTML
0

Total
0

Share

Search Panel

Ni Made Savitri Devi
Google Scholar
Pubmed
ISM Journal


Made Ratna Saraswati
Google Scholar
Pubmed
ISM Journal