Life-threatening medical emergency characterized by the abrupt-onset of severe hypertyhyroidism/ thyrotoxicosis
Mechanism: acute elevation in catecholamine levels or sensitivity to catecholamines, as seen in situations of acute stress including infection, surgery, trauma, childbirth
Thyroid storm is most commonly seen in patients with Graves disease, toxic nodular goitre and toxic follicular adenoma
Presenting clinical manifestations of thyroid storm include:
- Tachycardia, tachyarrhythmias
- Hyperpyrexia
- CNS dysfunction (agitation, delirium, coma)
- GI disturbances (nausea, vomiting, abdominal pain)
Typical lab results in patients with thyroid storm include:
- Decreased TSH
- Increased T3 and T4
- Elevated liver enzymes
Complications of thyroid storm which causing patient’s death:
- Tachyarrhythmias (notably atrial fibrillation and ventricular fibrillation) which are the most common cause of death in patients with thyroid storm
- Shock (heart failure, diarrhea/vomiting-induced volume depletion)
- Coma
Treatment:
- Antithyroid drugs- Propylthiouracil
- Beta Blockers-Propranolol
- Iodides:Potassium Iodide/iodine
- Steroids: Prednisone
- Bile acid resins-Cholestyramine
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