{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T02:18:49Z","timestamp":1780625929149,"version":"3.54.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T00:00:00Z","timestamp":1657929600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T00:00:00Z","timestamp":1657929600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["JA Clin Rep"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Thyroid storm is a life-threatening manifestation of thyrotoxicosis and presents with fever, diaphoresis, tachycardia, hypertension, and widened pulse pressure.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We present a case of intraoperative thyroid storm in a 12-year-old female undergoing posterior spinal fusion. Despite adequate depth of anesthesia and analgesia, the patient was persistently tachycardic and hypertensive. The surgical procedure was uneventful. A thyroid panel drawn immediately after surgery showed undetectable thyroid stimulating hormone (TSH) and high free thyroxine (T4) consistent with thyroid storm.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Intraoperative thyroid storm in a pediatric patient is extremely rare with nonspecific clinical symptoms. Low to undetectable TSH and elevated free T4 is diagnostic.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40981-022-00543-2","type":"journal-article","created":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T09:03:45Z","timestamp":1657962225000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnosis and management of intraoperative thyroid storm in a child with undiagnosed Graves\u2019 disease: a case report"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3600-4148","authenticated-orcid":false,"given":"Amanda W.","family":"Schaefer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro J.","family":"Solorzano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana C.","family":"Mavarez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo M.","family":"Mu\u00f1oz-Monaco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,7,16]]},"reference":[{"issue":"8","key":"543_CR1","doi-asserted-by":"publisher","first-page":"745","DOI":"10.1136\/adc.2003.035980","volume":"89","author":"G Birrell","year":"2004","unstructured":"Birrell G, Cheetham T. Juvenile thyrotoxicosis; can we do better? Arch Dis Child. 2004;89(8):745\u201350.","journal-title":"Arch Dis Child."},{"issue":"5","key":"543_CR2","doi-asserted-by":"publisher","first-page":"490","DOI":"10.1111\/pan.13130","volume":"27","author":"RM Gray","year":"2017","unstructured":"Gray RM. Anesthesia-induced rhabdomyolysis or malignant hyperthermia: Is defining the crisis important? Paediatr Anaesth. 2017;27(5):490\u20133.","journal-title":"Paediatr Anaesth."},{"issue":"2","key":"543_CR3","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1007\/s00540-011-1269-2","volume":"26","author":"T Bhalla","year":"2011","unstructured":"Bhalla T, Maxey D, Sawardekar A, Tobias JD. Anesthetic management of a pediatric patient with neuroleptic malignant syndrome. J Anesth. 2011;26(2):250\u20133.","journal-title":"J Anesth."},{"issue":"1","key":"543_CR4","doi-asserted-by":"publisher","first-page":"238e","DOI":"10.1097\/PRS.0000000000000784","volume":"135","author":"MJ Frederick","year":"2015","unstructured":"Frederick MJ, Colwell AS. Acute hypertensive crisis secondary to pheochromocytoma during elective cosmetic surgery. Plast Reconstr Surg. 2015;135(1):238e\u20139e.","journal-title":"Plast Reconstr Surg."},{"issue":"6","key":"543_CR5","doi-asserted-by":"publisher","first-page":"e393","DOI":"10.4158\/ACCR-2019-0261","volume":"5","author":"M Pandya","year":"2019","unstructured":"Pandya M, Garcia RA, Awori J. Thyrotoxicosis in a pediatric patient with supraventricular tachycardia and borderline features of thyroid storm. AACE Clin Case Rep. 2019;5(6):e393\u20135.","journal-title":"AACE Clin Case Rep."},{"issue":"5","key":"543_CR6","doi-asserted-by":"publisher","first-page":"305","DOI":"10.1159\/000320028","volume":"74","author":"SA Rivkees","year":"2010","unstructured":"Rivkees SA. Pediatric graves\u2019 disease: Controversies in management. Horm Res Paediatr. 2010;74(5):305\u201311.","journal-title":"Horm Res Paediatr."},{"issue":"1","key":"543_CR7","doi-asserted-by":"publisher","first-page":"132","DOI":"10.1016\/j.otohns.2006.06.1248","volume":"136","author":"MP Morrison","year":"2007","unstructured":"Morrison MP, Schroeder A. Intraoperative identification and management of thyroid storm in children. Otolaryngol Head Neck Surg. 2007;136(1):132\u20133.","journal-title":"Otolaryngol Head Neck Surg."},{"key":"543_CR8","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.jaut.2015.07.009","volume":"64","author":"HJ Lee","year":"2015","unstructured":"Lee HJ, Li CW, Hammerstad SS, Stefan M, Tomer Y. Immunogenetics of autoimmune thyroid diseases: A comprehensive review. J Autoimmun. 2015;64:82\u201390.","journal-title":"J Autoimmun."},{"issue":"10","key":"543_CR9","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1089\/thy.2016.0229","volume":"26","author":"DS Ross","year":"2016","unstructured":"Ross DS, Burch HB, Cooper DS, et al. 2016 American Thyroid Association Guidelines for Diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid. 2016;26(10):1343\u2013421.","journal-title":"Thyroid."},{"issue":"12","key":"543_CR10","doi-asserted-by":"publisher","first-page":"1212","DOI":"10.1111\/pan.12466","volume":"24","author":"JH Salazar","year":"2014","unstructured":"Salazar JH, Yang J, Shen L, Abdullah F, Kim TW. Pediatric malignant hyperthermia: Risk factors, morbidity, and mortality identified from the nationwide inpatient sample and Kids' Inpatient Database. Paediatr Anaesth. 2014;24(12):1212\u20136.","journal-title":"Paediatr Anaesth."},{"issue":"8","key":"543_CR11","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1213\/XAA.0000000000000074","volume":"3","author":"BD Laliberte","year":"2014","unstructured":"Laliberte BD, Goldenberg E, Reece-Stremtan SJ. Intraoperative diagnosis and treatment of thyroid storm in a 15-year-old male. A A Case Rep. 2014;3(8):107\u20139.","journal-title":"A A Case Rep."}],"container-title":["JA Clinical Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-022-00543-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40981-022-00543-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40981-022-00543-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,16]],"date-time":"2022-07-16T09:05:31Z","timestamp":1657962331000},"score":1,"resource":{"primary":{"URL":"https:\/\/jaclinicalreports.springeropen.com\/articles\/10.1186\/s40981-022-00543-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,16]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["543"],"URL":"https:\/\/doi.org\/10.1186\/s40981-022-00543-2","relation":{},"ISSN":["2363-9024"],"issn-type":[{"value":"2363-9024","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,16]]},"assertion":[{"value":"27 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 June 2022","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2022","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 July 2022","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s mother for publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"52"}}