Stephen LaFranchi, Author at Psychiatry Advisor

Stephen LaFranchi

All articles by Stephen LaFranchi

Myxedema coma

OVERVIEW: What every practitioner needs to know Are you sure your patient has myxedema coma? What are the typical findings for this disease? Myxedema coma occurs in patients with long-standing hypothyroidism and a precipitating stressful event. It is rare in children. The most common precipitating event is an infection, but it can occur following trauma,…

Thyrotoxicosis/thyroid storm

OVERVIEW: What every practitioner needs to know Thyroid storm is a rare disorder in children characterized by severe manifestations of thyrotoxicosis, but in addition, usual features include hyperthermia and altered mental status, ranging from agitation or delirium to extreme lethargy or coma, and, rarely, seizures. Presentation is usually triggered by a precipitating event, such as…

Sick-euthyroid syndrome

OVERVIEW: What every practitioner needs to know “Sick-euthyroid syndrome” occurs most commonly in acutely ill infants or children admitted to intensive care units, and is characterized by changes in serum thyroid hormone and TSH levels not caused by an intrinsic abnormality of thyroid function. Sick-euthyroid syndrome also can occur with starvation or with essentially any…

Graves' disease in infants and children

Are you sure the infant or child has Graves' Disease? Serum thyroid function tests confirming hyperthyroidism Total and free thyroxine (T4): Elevated Total and free triiodothyronine (T3): Elevated Thyroid stimulating hormone (TSH): Suppressed Serum TSH receptor stimulating antibody (TRS-Ab) tests confirming Graves' disease as the etiology Thyroid stimulating immunoglobulin (TSI): Elevated TSH receptor antibody (TRAb):…

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