Surgical Management of an Atypical Presentation of a Thyroid Storm

Abstract

Introduction:Thyroid storm is a rare complication of Graves' disease that can carry a poor prognosis. In order to prevent major complications, thyroid storm must be quickly identified in patients and treatment must be promptly implemented. Medical treatment is usually initiated with antithyroid medications, such as propylthiouracil (PTU), methimazole, and beta-blockers. However, some patients may experience adverse reactions to these medications and alternate treatment options must be explored.Case Presentation:We report a case of a 30-year-old female initiated on PTU after diagnosis with Graves' disease that later presented an acute thyroid storm.Discussion:Therapy was changed to methimazole, yet the patient subsequently developed angioedema and dyspnea. Medical management was discontinued and emergent thyroidectomy was performed without complication.

A Case of a Patient with Medical-Refractory Thyroid Storm Treated Successfully by Surgical Resection

“…1) Antithyroid drugs (ATDs) are the mainstay treatment for the control of thyrotoxicosis, and are effective. 2,3) However, in some cases, ATDs can have rare but severe side effects or fail to control disease progression. 4) In such cases, other treatments, such as therapeutic plasma exchange (TPE), radioiodine therapy, or thyroidectomy are required.…”