Affiliation:
1. EMERGENCY DEPARTMENT, UNIVERSITY HOSPITAL OF WAM, LODZ, POLAND
Abstract
Thyroid storm is a medical emergency. It comprises disorders of several organs and body systems, including disturbances of consciousness (also coma), heart failure, symptoms of shock, and high body temperature. The diagnosis of thyroid storm is challenging because it is based primarily on medical history and physical examination. Additional laboratory tests only perform an auxiliary function, and the initiation of therapy should not be delayed until the determination of thyroid hormones in the blood. Moreover, clinical symptoms often do not correlate with thyroid hormones concentration in the blood. Diarrhea, vomiting, and fever may lead to the diagnosis of thyroid storm. These are not typical symptoms of uncomplicated hyperthyroidism. The remaining symptoms of thyroid storm are symptoms of decompensation of individual organs and systems. When diagnosing thyroid storm, one uses the Burch and Wartofsky criteria. Accurate and quick diagnosis and implementation of initial treatment is the aim of pre-hospital management. These are fluid therapy, oxygen therapy, and antipyretic drugs. For this reason, it is essential not to delay the patient’s transport to the nearest hospital emergency department. One may also consider calling a specialist ambulance with a doctor who can give the right medication on the spot. Rapid treatment initiation can improve the status of most patients within 12-24 hours. Treatment delay worsens, and intensive treatment improves the prognosis in patients with thyroid storm. The mortality rate of thyroid storm has decreased and is now 20-30%.
Reference20 articles.
1. 1. Gajewski P. Interna Szczeklika 2019. Medycyna Praktyczna, Kraków 2019, pp. 1341-1342.
2. 2. Akamizu T, Satoh T, Isozaki O, et al. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys. Thyroid 2012;22:661-679. doi:10.1089/thy.2011.0334.
3. 3. Wartofsky L. Thyrotoxic storm. In: Braverman L, Utiger R (eds) Werner & Ingbar’s The Thyroid. 9th edn. Philadelphia: Williams & Wilkins, 2005, pp. 651-7.
4. 4. Swinburne JL, Kreisman SH. A rare case of subacute thyroiditis causing thyroid storm. Thyroid 2007;17:73-6.
5. 5. Palestini N, Valori MR, Carlin R, et al. Mortality, morbidity and long-term results in surgically treated hyperthyroid patients. Review of 597 cases. Acta Chir Scand. 1985;151:509-13.
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