Lesson of the Week: Thyrotoxicosis in a patient with multiple trauma: value of "AMPLE" history taking

Thyroid storm as a cause of unexplained tachycardia in acutely injured trauma patients

“…17 Trauma is a known, but rare, cause of exacerbated hyperthyroidism and thyroid storm with only eight cases reported in the English literature. 1,6,[8][9][10]19,23 The majority of patients who develop thyroid storm have underlying hyperthyroidism that has been either untreated or only partially treated. 17,5 The Jod-Basedow phenomenon is a welldescribed condition of iodine induced thyrotoxicosis that can range from mildly symptomatic hyperthyroidism to frank thyroid storm.…”

Malignant Hyperthermia in a Patient with Graves' Disease during Subtotal Thyroidectomy.

“…There are several reports of cases of life-threatening thyrotoxicosis during anesthesia that have mimicked malignant hyperthermia [9][10][11][12][13][14][15][16]. After the introduction of antithyroid drugs, however, the incidence of perioperative thyroid crises was reduced.…”

Case Studies

“…Echo‐color Doppler of the thyroid showed diffuse vascularization, diagnosing a trauma thyroiditis in active, transitory hyperthyroidism. It seemed very possible that the ultimate etiological factor was his playing of the violin [1,2], which had caused continuous microtraumas to his thyroidal micro‐architecture, with subsequent antithyroid antibody production, partial destruction of the gland, and release of large amounts of thyroid hormones into the bloodstream. Because the hyperthyroid phase in thyroiditis is usually self‐limiting (e.g., hypothyroidism is frequently observed later), the patient was not treated with antithyroid drugs to manage his hyperthyroidism directly.…”