{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T19:50:31Z","timestamp":1768074631344,"version":"3.49.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T00:00:00Z","timestamp":1686873600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p>Thyroid storm, though extremely rare in toddlers, requires prompt diagnosis and treatment because it can be fatal if left untreated. However, thyroid storm is not often considered in the differential diagnosis of a febrile convulsion due to its rarity in children. Herein, we report the case of a 3-year-old girl with thyroid storm who presented with febrile status epilepticus. Although the seizure was stopped by diazepam administration, her tachycardia and widened pulse pressure persisted, and severe hypoglycemia was observed. Based on the findings of thyromegaly, a history of excessive sweating and hyperactivity, and a family history of Graves' disease, she was eventually diagnosed with a thyroid storm. The patient was successfully treated with thiamazole, landiolol, hydrocortisone, and potassium iodide. Propranolol, a non-selective <jats:italic>\u03b2<\/jats:italic>-blocker, has been used to manage tachycardia during thyroid storm. However, a cardio-selective <jats:italic>\u03b2<\/jats:italic>1-blockers, landiolol hydrochloride, was used in our case to avoid worsening hypoglycemia. Febrile status epilepticus is one of the most common medical emergencies in childhood; it is necessary to rule out treatable underlying critical diseases such as septic meningitis and encephalitis. Thyroid storm should be considered in children presenting with prolonged febrile convulsion accompanied by findings that are not usually observed with febrile convulsions.<\/jats:p>","DOI":"10.3389\/fped.2023.1213040","type":"journal-article","created":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T04:55:13Z","timestamp":1686891313000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case report: Thyroid storm in a three-year-old girl presenting with febrile status epilepticus and hypoglycemia"],"prefix":"10.3389","volume":"11","author":[{"given":"Yusuke","family":"Aoki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Hanaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidemi","family":"Toyoda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Emori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masazumi","family":"Miyahara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Hirayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1542\/peds.2010-3318","article-title":"Neurodiagnostic evaluation of the child with a simple febrile seizure","volume":"127","year":"2011","journal-title":"Pediatrics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1111\/ped.13102","article-title":"Low cardiac output thyroid storm in a girl with Graves\u2019 disease","volume":"58","author":"Chantra","year":"2016","journal-title":"Pediatr Int"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1542\/peds.2019-1920","article-title":"Thyroid storm in a toddler presenting as a febrile seizure","volume":"145","author":"Ladd","year":"2020","journal-title":"Pediatrics"},{"key":"B4","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1515\/jpem-2022-0309","article-title":"Thyroid storm in pediatrics: a systematic review","volume":"36","author":"Abisad","year":"2023","journal-title":"J Pediatr Endocrinol Metab"},{"key":"B5","article-title":"Graves\u2019 disease: complications","volume-title":"Endotext. South. MDText.com","author":"Bartalena","year":"2023"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e210073","DOI":"10.1530\/ETJ-21-0073","article-title":"2022 European thyroid association guideline for the management of pediatric Graves\u2019 disease","volume":"11","author":"Mooij","year":"2022","journal-title":"Eur Thyroid J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"775","DOI":"10.1001\/archdermatol.2010.158","article-title":"Hypoglycemia in children taking propranolol for the treatment of infantile hemangioma","volume":"146","author":"Holland","year":"2010","journal-title":"Arch Dermatol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American thyroid association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis","volume":"26","author":"Ross","year":"2016","journal-title":"Thyroid"},{"key":"B9","doi-asserted-by":"publisher","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. 1st ed"},{"key":"B10","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1089\/thy.2011.0334","article-title":"Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys","volume":"22","author":"Akamizu","year":"2012","journal-title":"Thyroid"},{"key":"B11","doi-asserted-by":"publisher","first-page":"955","DOI":"10.1089\/thy.2009.0276","article-title":"The prevalence of thyrotoxicosis-related seizures","volume":"20","author":"Song","year":"2010","journal-title":"Thyroid"},{"key":"B12","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1177\/000992288902801204","article-title":"Thyroid storm. Presenting with coma and seizures. In a 3-year-old girl","volume":"28","author":"Aiello","year":"1989","journal-title":"Clin Pediatr (Phila)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1097\/RLU.0b013e31829af5ed","article-title":"Unexpected diagnosis of thyroid storm in a young child referred for urgent lung perfusion imaging","volume":"38","author":"Arsos","year":"2013","journal-title":"Clin Nucl Med"},{"key":"B14","doi-asserted-by":"publisher","first-page":"e14273","DOI":"10.7759\/cureus.14273","article-title":"Recurrent concurrent diabetic ketoacidosis and thyroid storm","volume":"13","author":"Crudo","year":"2021","journal-title":"Cureus"},{"key":"B15","doi-asserted-by":"publisher","first-page":"920","DOI":"10.1542\/peds.53.6.920","article-title":"Thyroid storm in an 11-year-old boy managed by propranolol","volume":"53","author":"Galaburda","year":"1974","journal-title":"Pediatrics"},{"key":"B16","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1515\/jpem-2011-0436","article-title":"Encephalopathy and sinustachycardia in childhood\u2013a possible differential diagnosis","volume":"25","author":"Hecht","year":"2012","journal-title":"J Pediatr Endocrinol Metab"},{"key":"B17","doi-asserted-by":"publisher","first-page":"101182","DOI":"10.1016\/j.rmcr.2020.101182","article-title":"Pediatric airway compromise due to thyroid storm associated with influenza A infection: a case report","volume":"31","author":"Higaki","year":"2020","journal-title":"Respir Med Case Rep"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1865","DOI":"10.1210\/jcem.86.5.7473","article-title":"Thyroid storm in a child following radioactive iodine (RAI) therapy: a consequence of RAI versus withdrawal of antithyroid medication","volume":"86","author":"Kadmon","year":"2001","journal-title":"J Clin Endocrinol Metab"},{"key":"B19","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1292\/cpe.22.39","article-title":"A case of Graves\u2019 disease diagnosed in the course of bilateral carotid artery stenoses (moyamoya disease); a case report and review of the literature","volume":"22","author":"Kamasaki","year":"2013","journal-title":"Clin Pediatr Endocrinol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1515\/jpem-2021-0219","article-title":"Neurological and gastrointestinal symptoms as an initial presentation of pediatric thyroid storm: report of three cases","volume":"34","author":"Nogami","year":"2021","journal-title":"J Pediatr Endocrinol Metab"},{"key":"B21","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1001\/archpedi.1993.02160330015002","article-title":"Thyrotoxicosis presenting with seizures and coma in two children","volume":"147","author":"Radetti","year":"1993","journal-title":"Am J Dis Child"},{"key":"B22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/bcr-2019-231090","article-title":"Atypical presentation of thyroid storm: a diagnostic dilemma","volume":"12","author":"Banerjee","year":"2019","journal-title":"BMJ Case Rep"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.2169\/internalmedicine.51.7974","article-title":"Thyroid storm with multiple organ failure, disseminated intravascular coagulation, and stroke with a normal serum FT3 level","volume":"51","author":"Harada","year":"2012","journal-title":"Intern Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"871","DOI":"10.2169\/internalmedicine.38.871","article-title":"Hypoglycemic coma masquerading thyrotoxic storm","volume":"38","author":"Homma","year":"1999","journal-title":"Intern Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1507\/endocrj.k09e-043","article-title":"A case of atypical thyroid storm with hypoglycemia and lactic acidosis","volume":"56","author":"Izumi","year":"2009","journal-title":"Endocr J"},{"key":"B26","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1378\/chest.118.3.877","article-title":"Thyroid storm presenting as multiple organ dysfunction syndrome","volume":"118","author":"Jiang","year":"2000","journal-title":"Chest"},{"key":"B27","doi-asserted-by":"publisher","first-page":"234","DOI":"10.2169\/internalmedicine.44.234","article-title":"Severe starvation hypoglycemia and congestive heart failure induced by thyroid crisis, with accidentally induced severe liver dysfunction and disseminated intravascular coagulation","volume":"44","author":"Kobayashi","year":"2005","journal-title":"Intern Med"},{"key":"B28","doi-asserted-by":"publisher","first-page":"168565","DOI":"10.1155\/2012\/168565","article-title":"Severe hypoglycemia accompanied with thyroid crisis","volume":"2012","author":"Nakatani","year":"2012","journal-title":"Case Rep Endocrinol"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1056\/NEJM199504273321707","article-title":"Hypoglycemic disorders","volume":"332","author":"Service","year":"1995","journal-title":"N Engl J Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1016\/j.jccase.2016.04.002","article-title":"Cardiac arrest caused by landiolol in a patient in thyroid crisis","volume":"14","author":"Misumi","year":"2016","journal-title":"J Cardiol Cases"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1213040\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,16]],"date-time":"2023-06-16T04:55:17Z","timestamp":1686891317000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1213040\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,16]]},"references-count":30,"alternative-id":["10.3389\/fped.2023.1213040"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1213040","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,16]]},"article-number":"1213040"}}