Thyroid Storm

Abstract

Audience: This is a practice oral boards case which may be given to emergency medicine (EM) residents at all levels of training and recent EM graduates.Introduction/Background: Thyroid storm is an acute, life-threatening endocrine emergency. It occurs when there is excess circulating thyroid hormone in the bloodstream. It may be precipitated by infection, surgery, pregnancy, trauma, thyroid medication changes, or iodinated contrast exposure. This condition must be quickly identified and treated by EM physicians in order to prevent morbidity and mortality. IThe mortality rate is between 10 and 30% 1 Understanding and treating thyroid storm is included in the 2019 Model of Clinical Practice of Emergency Medicine. 2 Educational Objectives: At the end of this practice oral boards case, the learner will: 1) assess a patient with altered mental status in an oral boards format; 2) review appropriate laboratory testing and diagnostic imaging; 3) identify signs and symptoms of thyroid storm and 4) review appropriate pharmacologic therapies with the proper sequence and timing.

Diagnostic criteria and scoring systems for thyroid storm: An evaluation of their utility – comparative review

“…[ 4 ] It offers a nuanced approach grounded in overall clinical presentation, contributing to the comprehensive landscape of thyroid storm assessment. [ 4 , 9 ]…”

Untreated Graves’ Disease Complicated by Thyroid Storm and High-Output Cardiac Failure: A Case Report

“…Thyrotoxicosis manifests clinically with symptoms including palpitations, heat intolerance, weight loss, tremors, and proximal muscle weakness [ 5 ]. However, thyroid storm represents an extreme manifestation of thyrotoxicosis, precipitated by factors such as infection, surgery, trauma, or discontinuation of antithyroid medications [ 6 ]. It is characterized by a sudden and severe exacerbation of symptoms, leading to multi-organ dysfunction and hemodynamic instability.…”