TY - JOUR T1 - Sepsis and thyroid storm in a patient with methimazole-induced agranulocytosis JF - BMJ Case Reports JO - BMJ Case Reports DO - 10.1136/bcr-2020-235536 VL - 13 IS - 7 SP - e235536 AU - Vaishnavi Divya Nagarajan AU - Alba Morales AU - Lawtanya Pleasant AU - Asha Shenoi Y1 - 2020/07/01 UR - http://casereports.bmj.com/content/13/7/e235536.abstract N2 - Paediatric hyperthyroidism cases are mostly caused by Grave’s disease. Thyroid storm is a life-threatening condition seen rarely, in severe thyrotoxicosis, occurring in about 1%–2% of patients with hyperthyroidism. Antithyroid medications and beta-blockers are typically the first-line management of thyroid storm. We report a challenging case of a 15-year-old girl who presented with thyroid storm in the setting of septic shock and methimazole-induced agranulocytosis. Since the first-line agents were contraindicated, plasmapheresis was used to control the thyroid storm and as a bridging therapy to the definitive therapy of early thyroidectomy. This is the first paediatric case report that outlines the use of plasmapheresis in the management of complicated thyrotoxicosis in a setting of septic shock. ER -