{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:33:32Z","timestamp":1787016812306,"version":"build-2736575974"},"reference-count":10,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,7,12]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Thyroid storm is a rare, life-threatening endocrine emergency with a high mortality rate of up to 30%. We present a unique management challenge of a critically ill patient who developed thyroid storm in the setting of a duodenal perforation from amphetamine-associated non-occlusive mesenteric ischaemia. The diagnosis of \u2018thyroid storm\u2019 was made based on clinical criteria and a Burch-Wartofsky score of 100. During emergent exploratory laparotomy, a 1 cm duodenal perforation with surrounding friable tissue was found and repaired. Intraoperatively, a nasogastric tube was guided distal to the area of perforation to allow for enteric administration of medications, which was critical in the setting of thyroid storm. Therapeutic plasma exchange achieved biochemical control of our patient\u2019s thyroid storm but ultimately did not prevent in-hospital mortality.<\/jats:p>","DOI":"10.1136\/bcr-2020-238889","type":"journal-article","created":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T14:06:46Z","timestamp":1629382006000},"page":"e238889","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Getting around the gut: a unique management challenge of thyroid storm precipitated by amphetamine-associated duodenal ischaemia leading to compromised enteric absorption"],"prefix":"10.1136","volume":"14","author":[{"given":"Jin Sol Gene","family":"Lee","sequence":"first","affiliation":[{"name":"Internal Medicine, University of California Davis, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian Elliott","family":"Brown","sequence":"additional","affiliation":[{"name":"Surgery, University of California Davis, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison M","family":"Semrad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of California Davis, Sacramento, California, USA"},{"name":"Endocrinology, Tahoe Forest Health System, Tahoe, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir A","family":"Zeki","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, University of California Davis, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,8,19]]},"reference":[{"key":"2025082800113048000_14.8.e238889.1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066613498053"},{"key":"2025082800113048000_14.8.e238889.2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229"},{"key":"2025082800113048000_14.8.e238889.3","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): The Japan Thyroid Association and Japan Endocrine Society Taskforce Committee for the establishment of diagnostic criteria and nationwide surveys for thyroid storm [Opinion]","volume":"63","author":"Satoh","year":"2016","journal-title":"Endocr 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