Switching Therapy from Intravenous Landiolol to Transdermal Bisoprolol in a Patient with Thyroid Storm Complicated by Decompensated Heart Failure and Gastrointestinal Dysfunction

Intern Med. 2017 Oct 1;56(19):2603-2609. doi: 10.2169/internalmedicine.8846-17. Epub 2017 Sep 6.

Abstract

Thyroid storm is a life-threatening disorder that remains a therapeutic challenge. Although β-blockers are the mainstay for treatment, their use can be challenging in cases complicated by rapid atrial fibrillation and decompensated heart failure. We present a case of thyroid storm-associated atrial fibrillation and decompensated heart failure complicated by gastrointestinal dysfunction secondary to diffuse peritonitis that was successfully managed by a switching therapy, in which the continuous intravenous administration of landiolol was changed to bisoprolol via transdermal patch, in the acute phase treatment. This switching therapy may offer a promising therapeutic option for this potentially lethal disorder.

Keywords: acute heart failure; atrial fibrillation; bisoprolol transdermal patch; critical care; landiolol; thyroid storm.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Administration, Cutaneous
  • Administration, Intravenous
  • Adrenergic beta-Antagonists / therapeutic use*
  • Adult
  • Atrial Fibrillation / complications*
  • Bisoprolol / therapeutic use*
  • Female
  • Gastrointestinal Diseases / complications*
  • Heart Failure / complications
  • Humans
  • Morpholines / therapeutic use*
  • Thyroid Crisis / drug therapy*
  • Thyroid Crisis / etiology*
  • Treatment Outcome
  • Urea / analogs & derivatives*
  • Urea / therapeutic use

Substances

  • Adrenergic beta-Antagonists
  • Morpholines
  • landiolol
  • Urea
  • Bisoprolol