{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T08:52:43Z","timestamp":1788079963889,"version":"build-2784847793"},"reference-count":52,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":266,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Endocrinology"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:p>A 38\u2010year\u2010old gentleman presented with thyroid storm with multiorgan involvement in the form of heart failure (thyrotoxic cardiomyopathy), respiratory failure (respiratory muscle fatigue), hepatic dysfunction, fast atrial fibrillation, pulmonary embolism, and disseminated intravascular coagulation (DIC). His Graves\u2019 disease (GD) remained undiagnosed for nearly 8 months because apart from weight loss, he has not had any other symptoms of thyrotoxicosis. The presentation of thyroid storm was atypical (apathetic thyroid storm) with features of depression and extreme lethargy without any fever, anxiety, agitation, or seizure. There were no identifiable triggers for the thyroid storm. Apart from mechanical ventilation and continuous veno\u2010venous renal replacement therapy in the intensive care unit, he received propylthiouracil (PTU), esmolol, and corticosteroids, which were later switched to carbimazole and propranolol with steroids being tapered down. He was diagnosed with thyrotoxic myopathy which, like GD, remained undiagnosed for long (fatigability). A high index of suspicion and a multidisciplinary care are essential for good outcome in these patients.<\/jats:p>","DOI":"10.1155\/2020\/8896777","type":"journal-article","created":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T22:14:10Z","timestamp":1600899250000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Apathetic Thyroid Storm with Cardiorespiratory Failure, Pulmonary Embolism, and Coagulopathy in a Young Male with Graves\u2019 Disease and Myopathy"],"prefix":"10.1155","volume":"2020","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5077-5088","authenticated-orcid":false,"given":"Abuobeida","family":"Ali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4340-3152","authenticated-orcid":false,"given":"Wail","family":"Mostafa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelius","family":"Fernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nyi","family":"Htwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2018.0275"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066613498053"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0243"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0889-8529(18)30165-8"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej16-0336"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2011.0334"},{"key":"e_1_2_9_7_2","unstructured":"WakinoM. L. SzumanG. ScosciaM. F.et al. The challenge of diagnosing thyroid storm: a comparison of the Japanese thyroid association criteria to de Burch Wartofsky point scale Proceedings of the 19th European Congress of Endocrinology: Endocrine Abstracts May 2017 Lisbon Portugal."},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2850"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2010.0383"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.7205\/milmed.173.6.609"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.28.3.447"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2013-200145"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.4183\/aeb.2019.522"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.5114\/aoms.2013.38685"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/omcr\/omz045"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.5079"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2012.0384"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1530\/edm-18-0012"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr3106w"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.422"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1111\/crj.12403"},{"key":"e_1_2_9_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13970"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1530\/EDM-13-0060"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.12659\/ajcr.902297"},{"key":"e_1_2_9_25_2","unstructured":"DeshpandeA. C.andTanD. G. S. L. A case of thyroid storm with systemic thromboembolism Proceedings of the Annual Meeting of the Endocrine Society March 2020 San Francisco CA USA."},{"key":"e_1_2_9_26_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.7992"},{"key":"e_1_2_9_27_2","doi-asserted-by":"publisher","DOI":"10.1530\/edm-19-0078"},{"key":"e_1_2_9_28_2","doi-asserted-by":"publisher","DOI":"10.1530\/edm-15-0052"},{"key":"e_1_2_9_29_2","doi-asserted-by":"crossref","unstructured":"AmirM. RahhalM. N. andCalles-EscandonJ. Rapid resolution of hyperthyroidism induced hepatic dysfunction with methimazole Proceedings of the Annual Meeting of the Endocrine Society March 2020 San Francisco CA USA.","DOI":"10.1210\/jendso\/bvaa046.1309"},{"key":"e_1_2_9_30_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-016-2126-z"},{"key":"e_1_2_9_31_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2482-14-108"},{"key":"e_1_2_9_32_2","doi-asserted-by":"publisher","DOI":"10.12659\/ajcr.890519"},{"key":"e_1_2_9_33_2","doi-asserted-by":"publisher","DOI":"10.1507\/endocrj.ej14-0073"},{"key":"e_1_2_9_34_2","doi-asserted-by":"publisher","DOI":"10.5603\/cj.2017.0064"},{"key":"e_1_2_9_35_2","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000009949"},{"key":"e_1_2_9_36_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.2681-19"},{"key":"e_1_2_9_37_2","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.73.855.61"},{"key":"e_1_2_9_38_2","doi-asserted-by":"publisher","DOI":"10.1210\/js.2019-00076"},{"key":"e_1_2_9_39_2","doi-asserted-by":"publisher","DOI":"10.4158\/ep.17.3.456"},{"key":"e_1_2_9_40_2","doi-asserted-by":"publisher","DOI":"10.1530\/eje-18-0678"},{"key":"e_1_2_9_41_2","doi-asserted-by":"publisher","DOI":"10.1159\/000490384"},{"key":"e_1_2_9_42_2","doi-asserted-by":"publisher","DOI":"10.1177\/2042018810382481"},{"key":"e_1_2_9_43_2","volume-title":"Clinical and Research Information on Drug-Induced Liver Injury","author":"LiverTox","year":"2012"},{"key":"e_1_2_9_44_2","doi-asserted-by":"publisher","DOI":"10.1177\/2324709617747903"},{"key":"e_1_2_9_45_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2013.00150"},{"key":"e_1_2_9_46_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2005.02249.x"},{"key":"e_1_2_9_47_2","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/5794054"},{"key":"e_1_2_9_48_2","unstructured":"Empalife.com. Thyroid-storm: a life-threatening disease that requires rapid stabilization 2020http:\/\/www.empalife.com\/thyroid-storm."},{"key":"e_1_2_9_49_2","unstructured":"MisraM. SinghalA. andCampbellD. Thyroid storm 2020 https:\/\/emedicine.medscape.com\/article\/925147-medication#5."},{"key":"e_1_2_9_50_2","doi-asserted-by":"publisher","DOI":"10.4103\/0973-0354.168898"},{"key":"e_1_2_9_51_2","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/2475843"},{"key":"e_1_2_9_52_2","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12949"}],"container-title":["Case Reports in Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/crie\/2020\/8896777.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/crie\/2020\/8896777.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/2020\/8896777","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T23:57:46Z","timestamp":1762473466000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/2020\/8896777"}},"subtitle":[],"editor":[{"given":"Wayne V.","family":"Moore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":52,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1155\/2020\/8896777"],"URL":"https:\/\/doi.org\/10.1155\/2020\/8896777","archive":["Portico"],"relation":{},"ISSN":["2090-6501","2090-651X"],"issn-type":[{"value":"2090-6501","type":"print"},{"value":"2090-651X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"2020-07-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"8896777"}}