An autopsy case of thyroid storm associated with chronic lymphocytic thyroiditis. (May 2020)

• Record Type: Journal Article
• Authors: Takahashi, Motonori; Kondo, Takeshi; Yamasaki, Gentaro; Sugimoto, Marie; Kuse, Azumi; Morichika, Mai; Nakagawa, Kanako; Ueno, Yasuhiro
• Is Part Of: Legal medicine. Volume 44(2020)
• Publication Date: 2020-05
• Subjects: CRP C-reactive protein -- T3 triiodothyronine -- T4 thyroxine -- TSH thyroid stimulating hormone; Thyroid toxicosis -- Hashimoto thyroiditis -- Postmortem biochemistry -- Medicolegal autopsy; Medical jurisprudence -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Medical jurisprudence; Periodicals; 614.1
• DOI: 10.1016/j.legalmed.2019.101624
• Languages: English
• ISSNs: 1344-6223

Abstract

Abstract: A Japanese woman in her 30s was found dead on a mattress. She had had fever, cough, and dyspnea for about 2 weeks. Gross examination at autopsy revealed slight enlargement of the thyroid gland and histopathological examination resulted in a diagnosis of chronic lymphocytic thyroiditis. The concentration of triiodothyronine in the cadaveric blood was extraordinarily high, whereas that of thyroid stimulating hormone was below the detection limit. Autoimmune antibodies against thyroid tissue were positive. The cause of death was assumed to be congestive heart failure caused by thyroid storm associated with chronic lymphocytic thyroiditis. Systemic histopathological examination of tissues and postmortem biochemistry can enable a diagnosis in medicolegal autopsies. Highlights: An autopsy case of thyroid storm with chronic thyroiditis is presented. The direct cause of death was heart failure caused by hyperthyroidism. Hyperthyroidism can induce focal myocardial fibrosis. The mechanism of death was identified by postmortem histological examination.