UNIVERSITAS AIRLANGGA



Detail Article

Folia Medica Indonesiana

ISSN 0303-7932

Vol. 43 / No. 4 / Published : 2007-10

Order : 13, and page :268 - 275

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Original Article :

Review article and clinical experience: graves’ disease and thyroid storm atd therapy, formulas ts – 41668, cs – 7.3.7

Author :

  1. Askandar Tjokroprawiro*1
  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Airlangga University School of Medicine, Dr. Soetomo Teaching Hospital, Jl Mayjen Mustopo 6-8, Surabaya

Abstract :

Thyroid Storm (TS) or Thyroid Crisis (TC) usually develops after some specific precipitating event such as infection, sepsis, trauma, cerebrovascular accident, or radioactive iodine therapy, etc. Thyroid Crisis may present as the so called masked or apapthic thyrotoxicosis (Ghobrial et al 2002), in which case signs and symptoms of the patient may be subtle, or not previously diagnosed with thyrotoxicosis (Hughes et al 2003). The clinical picture reflexes to severely exaggerated effects of thyroid hormones (THs). Heat intolerance and diaphoresis are common in simple thyrotoxicosis but manifest as hyperpyrexia in TS. The temperature is consistently higher than 38.5°C, but frequently exceeds 40°C. Excessive sweating may be frequently exist. In addition to the thermoregulatory dysfunction, other cardinal systems, such as CNS, Gastrointestinal-Hepatic System, and Cardiovascular System are fundamentally involved. Diagnosis of TS is primarily clinical based, and no specific laboratory tests are available. However, Burch-Wartofsky Point Score (BWPS) can be used as diagnostic criteria for TS (Burch et al 1993, Tietgens et al 1995). Formula 41668 (Tjokroprawiro 2002) and the revised Formula TS 41668-24-6 (Tjokroprawiro 2005) have been routinely used in Surabaya as guidelines of specific treatment of TS and for evaluation of its therapeutic clinical outcomes. Thyroid Crisis is an acute, life-threatening emergency with extremely high mortality (90%) in USA if early diagnosis is not made and the patients is left untreated. However, with better control of tyrotoxicosis and early treatment of TS, the mortality has decreased to less than 20%. This presentation or paper is intended for residents of internal medicine, internists, candidates of endocrinologists, and associated specialists, to recognize the rational therapy of TS, the Formula TS 41668-24-6 as its practical guidelines and to know how to apply the Formula CS 737 for the rationale administration of corticosteroid treatment.

Keyword :

Thyroid Storm (TS) or Thyroid Crisis (TC), Grave's Disease, ATD Therapy, Formulas TS – 41668 , CS – 7.3.7,


References :

Subramanian, S & Holt, AF,(2005) Hyperthyroidism, in KE Hendersons, TJ Baranski, PE Bickel (eds), The Washington Manual Endocrinology Subspecialty Consult - : Lippincot Williams & Wilkins

Burch, HB & Wartofsky, L,(1993) Life-threatening thyrotoxicosis: Thyroid Storm - : Endocrinol Metab Clin North Amer

Colebunders, R, Bordoux, P, Bekaert, J et al.,(1984) Determination of free thyroid hormones and their binding proteins in a patients with severe hyperthyroidism (thyroid storm?) and thyroid enaphalopathy - : J Endocrinol Invest





Archive Article

Cover Media Content

Volume : 43 / No. : 4 / Pub. : 2007-10
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  2. Effect Of Fish Oil On Blood Cholesterol Level In Rats Fed With Hypercholesterolemic Diet
  3. Cytologic Examination Using Swab Method To Evaluate Radiologic Outcome In Nasopharyngeal Carcinoma Patients Post-radiotherapy
  4. Role Of Anterior Decompression In Cervical Spondylosis Myelopathy: A Report Of 64 Cases
  5. Correlation Between Nutritional Status Of Pregnant Mothers And Aterm Birthweight In Dr Soetomo Hospital Surabaya, 1992
  6. Persistent Impairment Of Cerebral Cortices Due To Protein-energy Malnutrition (pem) Anatomical, Histological, And Physiological Perspectives
  7. Role Of Serum Neuron Specific Enolase (nse) To Differentiate Ischemic Stroke From Hemorrhagic Stroke And Its Correlation With Brain Damage Volume
  8. The Effect Of Low Level Laser Therapy In Carpal Tunnel Syndrome Patients
  9. Metabolic Syndrome In Patients With Mitochondrial Diabetes Mellitus
  10. Decreased Human Milk Immunity In Double Life Mothers
  11. Congenital Muscular Torticollis With Shortening Of Right Sternocleidomastoid Muscle. A Case Report
  12. Effect Of Acanthus Ilicifolius L Extract On The Reduction Of Tnf-α Expression In Wistar Strain Rattus Norvegicus
  13. Review Article And Clinical Experience: Graves’ Disease And Thyroid Storm Atd Therapy, Formulas Ts – 41668, Cs – 7.3.7

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