Abstract
A 69-year-old woman caught a cold resulting in nausea, vomiting, diarrhea and severe anorexia. Then she suffered progressively from dyspnea and leg edema, and finally became delirious. On admission severe hypoglycemia, hypothermia, marked tachycardia, generalized edema, mild jaundice and cachexy were noted. EKG showed atrial fibrillation. A chest X-ray, chest CT and echocardiography showed congestive heart failure. Therapeutic use of diuretics induced shock leading to serious liver dysfunction and disseminated intravascular coagulation. However, combined therapy by intravenous glucose, digitalis, diuretics, anti-fibrinolytic drug and hydrocortisone were effective. Addition of antithyroid therapy brought a further favorable outcome.
MeSH terms
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Aged
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Blood Glucose / metabolism
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Blood Pressure / drug effects
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Chemical and Drug Induced Liver Injury*
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Disseminated Intravascular Coagulation / blood
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Disseminated Intravascular Coagulation / chemically induced*
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Diuretics / adverse effects*
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Diuretics / therapeutic use
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Female
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Furosemide / adverse effects*
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Furosemide / therapeutic use
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Glucose / administration & dosage
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Glucose / therapeutic use
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Heart Failure / drug therapy
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Heart Failure / etiology*
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Heart Failure / physiopathology
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Humans
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Hypoglycemia / blood
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Hypoglycemia / drug therapy
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Hypoglycemia / etiology*
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Infusions, Intravenous
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Liver Diseases / enzymology
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Severity of Illness Index
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Starvation / blood
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Starvation / complications*
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Thyroid Crisis / blood
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Thyroid Crisis / complications*
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Thyroid Hormones / blood
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Transaminases / blood
Substances
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Blood Glucose
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Diuretics
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Thyroid Hormones
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Furosemide
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Transaminases
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Glucose