BMJ Case Reports 2012; doi:10.1136/bcr-2012-006696
  • Unusual presentation of more common disease/injury

Surviving the storm: two cases of thyroid storm successfully treated with plasmapheresis

  1. Ramaswami Nalini1
  1. 1Department of Medicine/Endocrinology, Baylor College of Medicine, Houston, Texas, USA
  2. 2Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
  1. Correspondence to Dr Ramaswami Nalini, nalini{at}


Thyroid storm is a rare, but critical, illness that can lead to multiorgan failure and carries a high death rate. The following case series describes two adult men with Graves’ disease who presented in thyroid storm and either failed or could not tolerate conventional medical management. However, both patients responded well to plasmapheresis, which resulted in clinical and biochemical stabilisation of their disease processes. The treatment option of plasmapheresis should be considered as a stabilising measure, especially when patients have failed or cannot tolerate conventional therapy. Plasmapheresis leads to amelioration of symptoms and a significant decline in thyroid hormone levels, providing a window to treat definitively with thyroidectomy.

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