Diagnosis dan Tata Laksana Thyroid Storm yang Dipicu oleh Perikarditis Akut

Abstract

Thyroid storm is a life-threatening condition that requires prompt diagnosis and emergency treatment. This condition manifests as multiple organ decompensation characterized by loss of consciousness, high fever, heart failure, diarrhea,and jaundice. We report a case of a 51-year-old man with a chief complaint of fever that has been felt since the night before admission. Body temperature was up to 38°C and started while he was resting. Patient also reported dry, intense cough, since five days ago, accompanied with shortness of breath when lying down. The patient also felt palpitations sincethe previous night and still felt until the morning of admission, and did not improve with rest. The patient was diagnosed by observation of suspension shock due to cardiogenic shock, suspect Graves’ disease (thyroid storm), ADHF profileB et causa suspect CAD, AF RVR, type 2 DM, myofascial pain syndrome with differential diagnosis: headache related toinfection, hyponatremia chronic asymptomatic hypoosmolar hypervolemic et causa suspect dilution, hypoalbuminemia etcausa suspect chronic inflammation, and upper respiratory tract infection. Thyroid storm cases require a multidisciplinaryapproach in terms of diagnosis and therapy. In this case, the patient is referred to the internal medicine, cardiac, andneurology departments.Krisis tiroid adalah kondisi yang mengancam jiwa dan memerlukan diagnosis segera serta perawatan darurat. Kondisi ini bermanifestasi sebagai gangguan atau dekompensasi pada beberapa organ disertai hilangnya kesadaran, demam tinggi, gagal jantung, diare, dan penyakit kuning. Kami melaporkan kasus seorang pria berusia 51 tahun dengan keluhan utama demam. Keluhan demam sudah dirasakan sejak malam sebelum masuk rumah sakit. Demam dimulai saat sedang beristirahat dan suhu tubuh mencapai 38°C. Pasien juga mengeluhkan batuk kering dengan intensitas yang cukup tinggi sejak lima hari sebelumnya disertai sesak napas saat berbaring. Pasien juga merasakan jantung berdebar sejak malam sebelumnya. Jantung berdebar dirasakan hingga pagi hari saat pendaftaran, dan keluhan tidak membaik setelah istirahat. Pasien didiagnosis berdasarkan observasi syok suspensi et causa syok kardiogenik, suspect penyakit Graves (krisis tiroid), ADHF profile B et causa suspect CAD, AF RVR, DM tipe II, sindrom nyeri myofascial dengan diagnosis banding: sakit kepala yang berhubungan dengan infeksi, hiponatremia kronik asimtomatik hipoosmolar hipervolemik et causa suspect pengenceran, hipoalbuminemia et causa suspect peradangan kronis, dan infeksi saluran pernapasan atas. Kasus badai tiroid memerlukan pendekatan multidisiplin dalam hal diagnosis dan terapi. Dalam hal ini, pasien dirujuk ke departemen internal, jantung, dan neurologi.