A Case of Thyroid Storm Caused by Thyroiditis

Newman, Katherine Quinn; Walthall, Leonidas

doi:10.1177/23247096221129468

Cited by 4 publications

(8 citation statements)

References 38 publications

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“…cases of destructive thyroiditis were reported among 356 with thyroid storm (10), although there have been reports of subacute thyroiditis (15)(16)(17)(18)(19) and drug (immune checkpoint inhibitors, amiodarone, or lithium)-induced destructive thyroiditis leading to thyroid storm (1,2). A literature search revealed only one previous report of painless thyroiditis causing thyroid storm (20), indicating that it is extremely rare.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, since destructive thyroiditis typically causes only mild to moderate thyrotoxicosis, it only rarely causes thyroid storm. In a nationwide survey conducted in Japan in 2012, only 5 cases of destructive thyroiditis were reported among 356 with thyroid storm ( 10 ), although there have been reports of subacute thyroiditis ( 15 - 19 ) and drug (immune checkpoint inhibitors, amiodarone, or lithium)-induced destructive thyroiditis leading to thyroid storm ( 1 , 2 ).…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Painless Destructive Thyroiditis Resulting in Thyroid Storm

et al. 2023

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Thyroid storm is a life-threatening clinical condition that is usually triggered by untreated or interrupted treatment of Graves' disease, leading to the sudden onset of severe thyrotoxicosis, which requires an immediate diagnosis and treatment based on diagnostic criteria. Cases of thyroid storm caused by painless/painless subacute thyroiditis are very rare. We herein report an 85-year-old man with features of severe thyrotoxicosis caused by painless/painless subacute thyroiditis who had no uptake of 99m TcO4 and was negative for thyroidstimulating hormone receptor antibodies. In thyroid storm patients in whom the findings are inconsistent with Graves' disease, careful follow-up and management are necessary, assuming the possibility of painless or painless subacute thyroiditis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Painless Destructive Thyroiditis Resulting in Thyroid Storm

et al. 2023

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Section: Discussionmentioning

confidence: 99%

“…TS is a rare but known complication of acute and subacute thyroiditis [ 10 ]. There are three phases of thyroiditis, beginning with a thyrotoxic phase, then transitioning to a hypothyroid state before settling into a euthyroid phase [ 10 ]. In the thyrotoxic phase, the inflamed thyroid follicles release excess thyroid hormones into the circulation [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…There are three phases of thyroiditis, beginning with a thyrotoxic phase, then transitioning to a hypothyroid state before settling into a euthyroid phase [ 10 ]. In the thyrotoxic phase, the inflamed thyroid follicles release excess thyroid hormones into the circulation [ 10 ]. The excessive release of thyroid hormones can then lead to a TS [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm

Joseph,

Karas,

Camba

et al. 2023

Cureus

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Thyroid storm (TS) is a relatively rare but life-threatening complication of an overactive thyroid that can manifest in a myriad of ways due to its multisystem involvement. Due to its relatively high mortality rate, it is essential that TS is recognized and treated promptly. TS can occur due to trauma, drugs, and sepsis. Identifying TS as a diagnosis is challenging to pinpoint due to its similar presentation to more common pathologies like sepsis and diabetic ketoacidosis (DKA). Here, we present a case of a 31-year-old African-American woman with type 2 diabetes mellitus following sepsis secondary to Escherichia coli pyelonephritis and DKA. Despite standard sepsis treatment, which included appropriate intravenous fluids and antibiotics, the patient did not improve. Further workup, utilizing the Burch-Wartofsky score, helped identify TS as the underlying cause of the patient’s hospitalization, despite no history of underlying thyroid disease. The inclusion of thyroid pathology as part of the differential diagnosis and workup of a patient with a sepsis-like presentation to avoid anchoring bias warrants further investigation.

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Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock

Elmenyar,

Aoun,

Al Saadi

et al. 2023

Diagnostics

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Thyroid storm (TS) is a rare and fatal endocrine emergency that occurs due to undiagnosed and inadequately treated hyperthyroidism after stressful conditions in patients with thyroid disorders. The objective of this systematic scoping review was to better understand the pathophysiology of TS and its complications, in terms of myocardial affection, tachyarrhythmia, and cardiogenic shock. In addition, we explored the pharmacological, mechanical, and surgical treatments for TS. We also evaluated the outcomes of TS according to sex and cardiac involvement. Additionally, analytical analysis was performed on the selected data. A literature review of peer-reviewed journals was carried out thoroughly using medical terms, MeSH on PubMed, Google Scholar, and combinations such as thyrotoxicosis-induced cardiomyopathy, thyroid storm, cardiogenic shock, myocardial infarction, endocrine emergency, Burch–Wartofsky score, extracorporeal circulatory support, and thyroidectomy. A total of 231 papers were eligible (2 retrospective studies, 5 case series, and 224 case reports) with a total of 256 TS patients with cardiac involvement between April 2003 and August 2023. All age groups, sexes, patients with TS-induced cardiomyopathy, non-atherosclerotic myocardial infarction, tachyarrhythmia, heart failure, shock, and different forms of treatment were discussed. Non-English language articles, cases without cardiac involvement, and cases in which treatment modalities were not specified were excluded. Female sex was predominant, with 154 female and 102 male patients. Approximately 82% of patients received beta-blockers (BBs), 16.3% were placed on extracorporeal membrane oxygenation (ECMO) support, 16.3% received therapeutic plasma exchange (TPE), and 13.8% underwent continuous renal replacement therapy (CRRT), continuous venovenous hemofiltration (CVVHD), or dialysis. Overall, 18 females and 16 males died. BB-induced circulatory collapse, acute renal failure, CRRT, and ventricular fibrillation were significantly associated with mortality. Awareness of TS and not only thyrotoxicosis is vital for timely and appropriate treatment. The early diagnosis and management of TS in cardiac settings, including pharmacological, mechanical, and surgical modalities, can save high-risk patients. Sex matters in the presentation, treatment, and mortality of this population. However, further large-scale, and well-designed studies are required.

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A Case of Thyroid Storm Caused by Thyroiditis

Cited by 4 publications

References 38 publications

A Rare Case of Painless Destructive Thyroiditis Resulting in Thyroid Storm

A Rare Case of Painless Destructive Thyroiditis Resulting in Thyroid Storm

Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm

Data Analysis and Systematic Scoping Review on the Pathogenesis and Modalities of Treatment of Thyroid Storm Complicated with Myocardial Involvement and Shock

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