Case Report: Occurrence of Thyroid Storm in a Young Patient With Recurrent Diabetic Ketoacidosis

Abstract

BackgroundThyroid storm (TS) is a fatal disease that leads to multiple organ failure and requires prompt diagnosis. Diabetic ketoacidosis (DKA) is a trigger for thyroid crisis. However, TS and DKA rarely occur simultaneously. Moreover, owing to the rarity of the co-occurrence, the clinical course remains unclear. In this study, we present a case of TS that developed during the follow-up for repeated DKA in a young patient.Case PresentationA 25-year-old man with a history of recurrent DKA was brought to the emergency room frequently with similar symptoms. DKA treatment was initiated, but his tachycardia and disturbance of consciousness did not improve. Further examination of the patient revealed a Burch–Wartofsky Point Scale score of 80 points, consistent with the Japan Thyroid Association criteria. Therefore, DKA coexisting with TS was diagnosed. Antithyroid medication, inorganic iodine, and corticosteroids were then started as treatment for TS, and β-blockers were administered to manage tachycardia. With these treatments, the patient’s health improved and he recovered.ConclusionsIn severe cases of recurrent DKA, the presence of TS should be considered, and early treatment should be initiated before the patient’s condition worsens.

A Case of Acute Neurologic Deficit and Hypoglycemia in the Setting of Thyroid Storm and Diabetic Ketoacidosis: A New Clinical Scenario

“…Under these conditions, the timely recognition of the prerequisites for TS and DKA is crucial. Prerequisite recognition depends on the presence of thyrotoxicosis and/or DM in a patient’s history as well as any potential triggering factors [ 5 ]. Triggering factors may ultimately lead to decompensating thyrotoxicosis or DM.…”

“…In contrast to DKA, the diagnosis of TS remains complicated; it is not based on laboratory parameters but on clinical symptom scoring, which may be obscured when both conditions co-exist. In most instances, hyperglycemia is considered as an initiating mechanism having less frequent associations with thyrotoxicosis exacerbations [ 4 , 5 ]. There is a pathophysiologic substantiation between the mutually potentiating effects of thyrotoxicosis and hyperglycemia or DKA [ 6 ].…”

Thyroid storm complicated by corpus callosum infarction in a young patient: A case report and literature review

“…Some scholars have reported cases of diabetic ketoacidosis complicated with TS. [1,32] And some scholars have reported cases of head and neck trauma or surgery-induced TS. [6]…”

“…Some scholars have reported cases of diabetic ketoacidosis complicated with TS. [1,32] And some scholars have reported cases of head and neck trauma or surgery-induced TS. [6] It is worth noting that inflammation may play an important role in the occurrence and development of thyroid storm and acute cerebral infarction.…”

“…A thyroid storm is a rare, life-threatening endocrine emergency caused primarily by large amounts of thyroid hormones in the bloodstream that leads to multiple organ dysfunction. [1] It occurs mainly in patients with untreated or inadequately treated hyperthyroidism for a long time. [2] Women are more likely to develop TS, which can occur at any age.…”