{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:50:33Z","timestamp":1753876233889,"version":"3.41.2"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,5,4]],"date-time":"2022-05-04T00:00:00Z","timestamp":1651622400000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Grant-in-Aid for Science Research","award":["21K08044"],"award-info":[{"award-number":["21K08044"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Thyroid storm (TS) complicated by cardiogenic shock is associated with high mortality due to the high incidence of multiple organ failure. It is recommended that TS patients with hepatic failure undergo plasma exchange (PE) and receive optimal anti-hyperthyroid medications. However, the effect of PE on cardiac dysfunction in TS patients has been unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 46-year-old woman was admitted to our hospital for dyspnoea and tachycardia. She was diagnosed with TS pursuant to Graves\u2019 disease complicated by acute decompensated heart failure (ADHF). Cardiac function was remarkably impaired [left ventricular ejection fraction (LVEF)\u2009=\u200915\u201320%], with rapid atrial fibrillation. Despite the management of both ADHF and hyperthyroidism, cardiogenic shock developed; therefore, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and intra-aortic balloon pumping (IABP) were initiated. Plasma exchange was performed after severe hepatic failure manifested on Day 2. After the first three PE treatments, cardiac and hepatic function improved immediately but deteriorated the next day. The improvement persisted after the fourth PE, and the patient was weaned from VA-ECMO and IABP on Days 10 and 11, respectively. She was discharged on Day 37, and her cardiac function was still normal 1.5 years later.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>In hyperthyroidism, severe hepatic dysfunction is more likely to occur in patients with acute ADHF than in those without it. Plasma exchange has the potential to improve not only hepatic but also cardiac dysfunction under optimal antithyroid treatment, especially in patients with TS complicated by severe hepatic dysfunction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytac197","type":"journal-article","created":{"date-parts":[[2022,5,5]],"date-time":"2022-05-05T19:46:09Z","timestamp":1651779969000},"source":"Crossref","is-referenced-by-count":2,"title":["Continuous improvement of both hepatic and cardiac dysfunction by sequential plasma exchange in a patient with thyrotoxicosis and cardiogenic shock: a case report indicating the potential role of cardiohepatic interactions during thyroid storm"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9386-2432","authenticated-orcid":false,"given":"Toshiaki","family":"Suzuki","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, 564-8565 Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9009-7234","authenticated-orcid":false,"given":"Yasuhide","family":"Asaumi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, 564-8565 Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6307-5593","authenticated-orcid":false,"given":"Yu","family":"Kataoka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, 564-8565 Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-4932","authenticated-orcid":false,"given":"Teruo","family":"Noguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-shimmachi, 564-8565 Suita, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,4]]},"reference":[{"key":"2022052017264588500_ytac197-B1","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1210\/jc.2014-2850","article-title":"Clinical features and hospital outcomes in thyroid storm: a retrospective cohort study","volume":"100","author":"Angell","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"2022052017264588500_ytac197-B2","first-page":"1","article-title":"Plasma exchange and early thyroidectomy in thyroid storm requiring extracorporeal membrane oxygenation","volume":"2019","author":"Koh","year":"2019","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"key":"2022052017264588500_ytac197-B3","doi-asserted-by":"crossref","first-page":"2801","DOI":"10.2169\/internalmedicine.50.6078","article-title":"A case of thyroid storm with multiple organ failure effectively treated with plasma exchange","volume":"50","author":"Sasaki","year":"2011","journal-title":"Intern Med"},{"key":"2022052017264588500_ytac197-B4","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1002\/jca.21705","article-title":"Guidelines on the use of therapeutic apheresis in clinical practice \u2013 evidence-based approach from the writing committee of the American society for apheresis: the eighth special issue","volume":"34","author":"Padmanabhan","year":"2019","journal-title":"J Clin Apher"},{"key":"2022052017264588500_ytac197-B5","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1507\/endocrj.EJ16-0336","article-title":"2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (first edition)","volume":"63","author":"Satoh","year":"2016","journal-title":"Endocr J"},{"key":"2022052017264588500_ytac197-B6","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1016\/j.jacc.2018.10.085","article-title":"Left ventricular unloading during extracorporeal membrane oxygenation in patients with cardiogenic shock","volume":"73","author":"Russo","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2022052017264588500_ytac197-B7","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1002\/ehf2.13097","article-title":"Predicting parameters for successful weaning from veno-arterial extracorporeal membrane oxygenation in cardiogenic shock","volume":"8","author":"Sawada","year":"2021","journal-title":"ESC Heart Fail"},{"key":"2022052017264588500_ytac197-B8","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/00004836-199204000-00010","article-title":"Hyperthyroidism and hepatic dysfunction. 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