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CASE REPORT
QT prolongation in a child with thyroid storm
  1. Benjamin B Albert1,
  2. Luke Gerard Eckersley2,
  3. Jonathan Robert Skinner2,
  4. Craig Jefferies3
  1. 1Liggins Institute, University of Auckland, Auckland, New Zealand
  2. 2Greenlane Paediatric and Congenital Cardiac Service, Starship Children's Health, Auckland, New Zealand
  3. 3Department of Paediatric Endocrinology, Starship Children's Hospital, Auckland, New Zealand
  1. Correspondence to Dr Luke Gerard Eckersley, lukeeckersley{at}hotmail.com

Summary

A 12-year-old girl presented with an acute confusional state and a 2-year history of weight loss, anxiety, agitation and recurrent fever. Thyroid function tests confirmed severe hyperthyroidism, and a diagnosis of thyroid storm was made (Burch and Wartofsky score=75). ECG showed a prolonged QTc interval of 506 ms. Acute treatment for thyroid storm consisted of Lugol's iodine, prednisolone, carbimazole and propranolol. She made a steady recovery and by 3 months her thyroid function had normalised; a repeat ECG showed a QTc within the normal range (430 ms). There was no relevant family history. This is a case of QTc prolongation with hyperthyroidism and normalisation with euthyroidism. It is not commonly recognised that hyperthyroidism in children may be associated with QTc prolongation. QTc measurement should be incorporated into management protocols for hyperthyroidism.

https://doi.org/10.1136/bcr-2013-202595

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