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CASE REPORT
Year : 2007  |  Volume : 4  |  Issue : 3  |  Page : 84-88

Acute medical thyroid storm - a report of 7 cases


Dr. Nairís Hospital, Residency Road, Kollam - 691002, India

Correspondence Address:
V Balachandran
Dr. Nairís Hospital, Residency Road, Kollam - 691002
India
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Source of Support: None, Conflict of Interest: None


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Acute thyroid storm is a disease state that results from thyroid hormone induced hyper-metabolism. The excess thyroid hormone is released from the thyroid gland as a result of excess thyroid production, or by processes that disrupt the follicular structure of the gland with subsequent release of stored hormone. Thyroid storm may lead to irreversible cardio vascular collapse and death if proper treatment is not initiated immediately. We had seen 7 cases of acute thyroid crisis in various medical emergencies both causing the medical emergencies and as well as aggravating the existing medical illness. All the patients had the classical features of tachycardia, delirium, altered sensorium and hyper dynamic cardiac failure. Three patients had acute atrial fibrillation causing CCF and stroke; one had post partum supraventricular tachycardia; three cases had pneumonia with ARDS. All had strenuous in-hospital course not responding to conventional treatment and responded dramatically to anti-thyroid drugs and iodine. There was a delay in suspecting and instituting the proper treatment. One must suspect acute thyroid crisis in all cases of unexplained coma, medical conditions not responding to treatment like CVA, acute pulmonary edema, atrial fibrillation and thromboembolism, ARDS and MOSF, seizures and myoclonus, post irradiation and supra ventricular tachycardia.


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