Thyroid Storm
Also written as TS.
Thyroid storm – an acute, life‑threatening decompensation of hyperthyroidism characterised by multisystem hypermetabolism, usually precipitated by a stressor in a patient with untreated or inadequately treated Graves’ disease or toxic nodular goitre.
Thyroid Storm
- Description : A life-threatening crisis of acute hyperthyroidism where symptoms are significantly heightened.
- Causes : Can be triggered by surgery, radioactive iodine therapy, uncontrolled diabetes, stress, abrupt withdrawal of antithyroid medications, or other precipitating events.
Read this in LECTURE 4: Thyroid Hormones
Thyroid Storm (Thyrotoxic Crisis)
- This is a life-threatening exacerbation of hyperthyroidism, presenting with high fever, extreme tachycardia, hypertension, agitation, delirium, and coma. Treatment involves antithyroid drugs, beta-blockers, iodine, hydrocortisone, and suppo
Read this in ENDOCRINE PATHOLOGY
What our notes say
- Thyroid storm – an acute, life‑threatening decompensation of hyperthyroidism characterised by multisystem hypermetabolism, usually precipitated by a stressor in a patient with untreated or inadequately treated Graves’ disease or toxic nodular goitre. (Thyroid storm and myxoedema coma)
- Thyroid storm, wound infection, scar, hypothyroidism, and tracheomalacia. (Integrated case paper: Medicine, Surgery, Gynaecology and Paediatrics (160 marks)
- Endocrinology and metabolism — diabetes mellitus; DKA and HHS; hypoglycaemia; hypothyroidism and thyrotoxicosis; thyroid storm and myxoedema coma; adrenal insufficiency and Cushing syndrome; calcium and parathyroid disorders; pituitary disease; obesity and metabolic syndrome. (Year 4 Internal Medicine: Exam Revision Roadmap)
- "Sepsis Mimics": Non-infectious causes of acute high fever include thyroid storm, heat stroke, neuroleptic malignant syndrome, and severe drug reactions (DRESS). (Approach to fever)
- *After reading this note you will be able to recognise, grade and initiate safe emergency management of thyroid storm and myxoedema coma, while knowing which local protocols (Kenya MoH & hospital formulary) must be consulted for drug choices and dosing.* (Thyroid storm and myxoedema coma)
- Thyroid Storm: PTU + iodine + beta-blockers + corticosteroids + supportive care (Basic Pharmacology - Study Guide)
Study material on Thyroid Storm
Practice questions on Thyroid Storm
Thyroid storm (thyrotoxic crisis) is differentiated from uncomplicated hyperthyroidism by
- T3 levels
- T4 levels
- TSH suppression
- Clinical scoring (Burch-Wartofsky) and marked fever/tachycardia
Answer: D. Laboratory values do not reliably distinguish; clinical criteria (Burch-Wartofsky score) are used.
Thyroid storm is a life-threatening complication of hyperthyroidism precipitated by
- Gradual withdrawal of antithyroid drugs
- Stress, surgery, infection, or radioiodine in uncontrolled hyperthyroidism
- Hypothyroidism treated with excess thyroxine
- Iodine deficiency
Answer: B. Thyroid storm: hyperpyrexia, tachycardia/arrhythmias, agitation, vomiting, high-output cardiac failure. Mortality ~20–30%. Treatment: propylthiouracil (blocks synthesis AND T4→T3 conversion) + Lugol's iodine + propranolol + steroids + supportive care.