Thyroid Storm: Clinical Manifestation, Pathophysiology, and Treatment

Pandey, Rahul; Kumar, Sanjeev; Kotwal, Narendra

doi:10.5772/intechopen.89620

Cited by 6 publications

(13 citation statements)

References 81 publications

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“…A thyroid storm or thyrotoxic crisis is a relatively rare, life-threatening endocrine emergency. 1,2 The prevalence is 1-2% among patients admitted for thyrotoxicosis. 1,2 It has a mortality of 10-20%.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 The prevalence is 1-2% among patients admitted for thyrotoxicosis. 1,2 It has a mortality of 10-20%. 1 It results from decompensated thyrotoxicosis with increased activity of the thyroid hormones, exceeding the patient's metabolic demands.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 It has a mortality of 10-20%. 1 It results from decompensated thyrotoxicosis with increased activity of the thyroid hormones, exceeding the patient's metabolic demands. 2,3 Thyroid storm usually develops in a setting of a specific precipitating event such as surgery, infection, sepsis, trauma, cerebrovascular accident, drugs, an acute iodine load, or parturition.…”

Section: Introductionmentioning

confidence: 99%

“…2,3 Thyroid storm usually develops in a setting of a specific precipitating event such as surgery, infection, sepsis, trauma, cerebrovascular accident, drugs, an acute iodine load, or parturition. 1,2,3 Clinical picture comprises an exaggerated feature of hyperthyroidism such as hyperthermia, tachycardia, hypertension, severe agitation, and altered mental status. 1,2,3 The basis for diagnosis is formed by clinical presentation and laboratory findings.…”

Section: Introductionmentioning

confidence: 99%

“…1,2,3 Clinical picture comprises an exaggerated feature of hyperthyroidism such as hyperthermia, tachycardia, hypertension, severe agitation, and altered mental status. 1,2,3 The basis for diagnosis is formed by clinical presentation and laboratory findings. A semi-quantitative scale called Burch-Wartofsky Score was developed to help assess the presence and severity of the most common signs and symptoms and thereby create a more objective basis for establishing the diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Pancytopenia and Hypoglycemia – Atypical Presentations of Thyrotoxicosis

Amalia¹,

Nasution²,

Soetedjo³

2022

J. Med. Health

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Pancytopenia and hypoglycemia are atypical presentations and potentially devastating complications of thyrotoxicosis which may lead to delayed diagnosis. This case report aims to describe atypical presentations of thyrotoxicosis. A case report of a 55-year-old man who was admitted with a history of epigastric pain for seven days, accompanied by malaise, weight loss, clammy hand, increase in appetite followed by a decrease in appetite, diarrhea, nausea, nervousness, and restlessness, palpitation, easy fatigability, and fever which happened for the past one month until the day he was admitted on 13 October 2020 to Sumedang General Hospital. He was treated accordingly. Laboratory examination showed pancytopenia, hypoglycemia, and low Thyroid Stimulating Hormone level. The Electrocardiogram showed atrial fibrillation and left ventricular strain. The patient was diagnosed with Thyroid Crisis. After four days of treatment, the clinical condition of the patient was getting better. Conclusion, history taking of previous symptoms and disease is becoming significant to establish a working diagnosis. A thorough history taking could help a physician to consider hyperthyroidism as a differential diagnosis not merely based on laboratory results. Recognition of unusual thyrotoxicosis presentations is important in early diagnosis and effective treatment of the disease to prevent further complication and morbidity.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Pancytopenia and Hypoglycemia – Atypical Presentations of Thyrotoxicosis

Amalia¹,

Nasution²,

Soetedjo³

2022

J. Med. Health

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Coexistence of Graves’ disease with acute rheumatic fever treated as thyroid storm in young Thai patient

Onsoi

Srilanchakon

Aroonparkmongkol

et al. 2023

Journal of Pediatric Endocrinology and Metabolism

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Objectives This report presents a case of acute onset of chorea, concurrent Graves’ disease, and acute rheumatic fever in an 8-year-old female patient. Case presentation The child had intermittent involuntary movement of all extremities and both eyes for 4 days, with a previous history of increased appetite, weight lost, and heat intolerance over a period of two months. Physical examination revealed fever, tachycardia, exophthalmos, eyelid retraction, as well as diffused thyroid enlargement. Initial clinical features and thyroid function testing suggested a thyroid storm due to Graves’ disease. Methimazole, propranolol, potassium iodide (SSKI), and dexamethasone were prescribed. Congestive heart failure developed after propranolol and cardiovascular re-evaluation and Revised Jones criteria suggested acute rheumatic fever. Chorea was successfully treated with pulse methylprednisolone. Conclusions We reported Graves’ disease patients with acute rheumatic fever simulating a thyroid storm. The underlying cardiac disease must be considered, especially where chorea and congestive heart failure are present.

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Thyroid storm in an uncontrolled graves’ disease with multiple complications: a case report

Widiana,

Wulandari

2023

Int J Adv Med

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Thyroid storm is an acute and life-threatening condition. Graves’ disease is the most common cause of thyroid storm. In this case, reported an uncontrolled Graves’ disease patient with multiple complications progressing to thyroid storm. A 33-years-old woman was admitted to the emergency department with agitation. Patient had a history of uncontrolled hyperthyroidism four years ago. From physical examination found exophthalmos, bibasilar rales in both lungs, shifting dullness on stomach, swollen feet, and cold extremities. The ECG showed an atrial fibrillation with rapid ventricular response. Thyroid stimulating hormone (TSH) was found very low with 0.02 mIU/L and very high free thyroxine (FT4) with 5.04 ng/dL. The neck USG showed thyroiditis and bilateral neck lymphadenopathy. The patient was hospitalized for 9 days (4 days in ICCU and 5 days in the general ward). A very high thyroid hormone receptor antibody (TRab) of 35.9 signified a diagnosis of Graves’ disease. The patient had a total Burch-Wartofsky point scale (BWPS) score of 80 and highly suggestive of a thyroid storm. Multiple complications of Graves’ disease are cardiac failure, atrial fibrillation, seizures, vomiting, abdominal cramps, diarrhea, elevated liver enzymes, coma, jaundice, and thromboembolism while in this case the patient had cardiac failure, atrial fibrillation, and elevated liver enzymes. Thyroid storm is diagnosed with clinical features not on laboratory results. It is important to evaluate multiple complications of Graves’ disease as an early warning to reduce the mortality of thyroid storm.

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Thyroid Storm: Clinical Manifestation, Pathophysiology, and Treatment

Cited by 6 publications

References 81 publications

Pancytopenia and Hypoglycemia – Atypical Presentations of Thyrotoxicosis

Pancytopenia and Hypoglycemia – Atypical Presentations of Thyrotoxicosis

Coexistence of Graves’ disease with acute rheumatic fever treated as thyroid storm in young Thai patient

Thyroid storm in an uncontrolled graves’ disease with multiple complications: a case report

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