Author: Marius Holmes / Editor: Tajek B Hassan / Reviewer: Kaja Mohammad Rasheed, Tadgh Moriarty / Code: / Published: 16/03/2022
Thyroid storm is a rare but life-threatening endocrine condition that should be considered, recognised and treated quickly. It is usually seen in patients with pre-existing Graves disease and is often caused by a physiological stress, particularly infection.
Synonyms
Thyrotoxic storm, accelerated hyperthyroidism, Thyrotoxic crisis
After completing this session you will be able to:
- Describe the abnormalities of function and regulation of the thyroid which lead to thyrotoxicosis and thyroid storm
- Recognise signs and symptoms of thyrotoxicosis and thyroid storm
- Plan and assess the treatment of thyroid storm
- Evaluate the response to treatment
References:
- Pimentel L, Hansen KN. Thyroid disease in the emergency department: a clinical and laboratory review. J Emerg Med. 2005 Feb;28(2):201-9.
- Guyton AC, Hall JE. Textbook of Medical Physiology. 10th Ed, Saunders, 2000.
- Mistovich JJ, Krost WS, Limmer DD. Beyond the basics: endocrine emergencies. Part 1: Hyperthyroidism and thyroid storm. EMS Mag. 2007 Oct;36(10):123-7; quiz 128-9.
- Burch HB, Wartofsky L. Life-threatening thyrotoxicosis. Thyroid storm. Endocrinol Metab Clin North Am. 1993 Jun;22(2):263-77. PMID: 8325286.
- Rennie D. Thyroid storm. JAMA. 1997 Apr 16;277(15):1238-43. PMID: 9103350.
- Migneco A, Ojetti V, Testa A, et al. Management of thyrotoxic crisis. Eur Rev Med Pharmacol Sci. 2005 Jan-Feb;9(1):69-74.
- McGugan EA. Hyperpyrexia in the emergency department. Emerg Med (Fremantle). 2001 Mar;13(1):116-20.
- Nayak B, Burman K. Thyrotoxicosis and thyroid storm. Endocrinol Metab Clin North Am. 2006 Dec;35(4):663-86, vii.
- Duggal J, Singh S, Kuchinic P, et al. Utility of esmolol in thyroid crisis. Can J Clin Pharmacol. 2006 Fall;13(3):e292-5. Epub 2006 Nov 26.
- Kearney T, Dang C. Diabetic and endocrine emergencies. Postgrad Med J. 2007 Feb;83(976):79-86.
- Kannan CR, Seshadri KG. Thyrotoxicosis. Dis Mon. 1997 Sep;43(9):601-77. PMID: 9301645.
- Dillmann WH. Thyroid storm. Curr Ther Endocrinol Metab. 1997;6:81-5. PMID: 9174709.
- Idrose A. Hyperthyroidism. In: Tintinalli JE, Stapczynski J, Ma O, Yealy DM, Meckler GD, Cline DM. eds. Tintinallis Emergency Medicine: A Comprehensive Study Guide, 8e. McGraw Hill; 2016.
- Vaidya B, Pearce S H S. Diagnosis and management of thyrotoxicosis. BMJ 2014; 349 :g5128.
- Ross DS, Burch HB, Cooper DS, Greenlee MC, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-1421.
- Milner MR, Gelman KM, Phillips RA, et al. Double-blind crossover trial of diltiazem versus propranolol in the management of thyrotoxic symptoms. Pharmacotherapy 1990; 10:100.