Thyroid storm

Thyroid storm or thyrotoxic crisis is a rare, life-threatening condition characterized by severe clinical manifestations of thyrotoxicosis. It represents a medical emergency requiring immediate treatment.

Signs and Symptoms

Thyroid storm is characterized by a high fever (often above 40°C/104°F), tachycardia (heart rate greater than 140 beats per minute or irregular heart rate (atrial fibrillation)), and altered mental status (agitation, confusion, delirium, psychosis, stupor, coma). Other symptoms may include nausea, vomiting, diarrhea, jaundice, and even heart failure.

Causes

Thyroid storm is usually precipitated by a stressor in patients with pre-existing hyperthyroidism. Common triggers include infection, trauma, surgery, radioactive iodine therapy, and withdrawal from anti-thyroid medication.

Diagnosis

The diagnosis of thyroid storm is based on clinical criteria. The Burch-Wartofsky Point Scale (BWPS) is often used to assess the likelihood of thyroid storm based on various clinical parameters.

Treatment

The treatment of thyroid storm involves supportive care, inhibition of thyroid hormone synthesis and release, inhibition of thyroid hormone effects, and treatment of the precipitating cause.

See Also

• Hyperthyroidism
• Hypothyroidism
• Thyroid

References

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