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    Thyrotoxic Crisis ( Thyroid Storm')

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    Roopa Lexmy Muniandy
    Thyrotoxic crisis, also known as thyroid storm, is a rare but life-threatening complication of thyrotoxicosis characterized by fever, agitation, delirium, tachycardia or atrial fibrillation, and cardiac failure. It is a medical emergency with a 10% mortality rate. Thyrotoxic crisis is commonly precipitated by infection in a patient with previously unrecognized or inadequately treated thyrotoxicosis and requires immediate treatment including rehydration, beta blockers, antithyroid medications, and sometimes corticosteroids to prevent complications like cardiac failure and death.

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    Thyrotoxic Crisis ( Thyroid Storm')

    Uploaded by

    Roopa Lexmy Muniandy
    76 views7 pages
    Thyrotoxic crisis, also known as thyroid storm, is a rare but life-threatening complication of thyrotoxicosis characterized by fever, agitation, delirium, tachycardia or atrial fibrillation, and cardiac failure. It is a medical emergency with a 10% mortality rate. Thyrotoxic crisis is commonly precipitated by infection in a patient with previously unrecognized or inadequately treated thyrotoxicosis and requires immediate treatment including rehydration, beta blockers, antithyroid medications, and sometimes corticosteroids to prevent complications like cardiac failure and death.

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    hyperthyroid crisis

    Original Title

    tyroid storm

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    Thyrotoxic crisis, also known as thyroid storm, is a rare but life-threatening complication of thyrotoxicosis characterized by fever, agitation, delirium, tachycardia or atrial fibrillation, and cardiac failure. It is a medical emergency with a 10% mortality rate. Thyrotoxic crisis is commonly precipitated by infection in a patient with previously unrecognized or inadequately treated thyrotoxicosis and requires immediate treatment including rehydration, beta blockers, antithyroid medications, and sometimes corticosteroids to prevent complications like cardiac failure and death.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    76 views7 pages

    Thyrotoxic Crisis ( Thyroid Storm')

    Uploaded by

    Roopa Lexmy Muniandy
    Thyrotoxic crisis, also known as thyroid storm, is a rare but life-threatening complication of thyrotoxicosis characterized by fever, agitation, delirium, tachycardia or atrial fibrillation, and cardiac failure. It is a medical emergency with a 10% mortality rate. Thyrotoxic crisis is commonly precipitated by infection in a patient with previously unrecognized or inadequately treated thyrotoxicosis and requires immediate treatment including rehydration, beta blockers, antithyroid medications, and sometimes corticosteroids to prevent complications like cardiac failure and death.

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    of 7

    3.

    Thyrotoxic crisis (‘Thyroid storm’)


    • This is a rare but life-threatening complication of
    thyrotoxicosis.
    • The most prominent signs are fever, agitation, delirium,
    tachycardia or atrial fibrillation and, in the older patient,
    cardiac failure.
    • Thyrotoxic crisis is a medical emergency and has a
    mortality of 10% despite early recognition and treatment.
    Etiology
    • It is most commonly precipitated by infection in a patient with
    previously unrecognised or inadequately treated thyrotoxicosis.
    • It may also develop in known thyrotoxicosis shortly after
    thyroidectomy in an ill-prepared patient or within a few days of
    131I therapy, when acute radiation damage may lead to a
    transient rise in serum thyroid hormone levels.
    • Anesthesia induction
    • Diabetic ketoacidosis
    • Drugs : NSAID, chemotherapy
    • Withdrawal of or noncompliance with antithyroid medications
    The Burch–Wartofsky system may
    be used to help establish the
    diagnosis.
    Investigation
    • Thyroid function test:
    -Elevated triiodothyronine (T3), thyroxine (T4), and free T4 levels.
    -suppressed TSH levels
    -elevated 24-hour iodine uptake

    • Chest radiography :
    -cardiac enlargement due to congestive heart failure
    -reveal pulmonary edema caused by heart failure

    • Head computed tomography (CT) scanning


    -may be necessary to exclude other neurologic conditions if diagnosis is uncertain after the initial
    stabilization of a patient who presents with altered mental status.
    Management:
    • Patients should be rehydrated and given propranolol, either
    orally (80 mg 4 times daily) or intravenously (1–5 mg 4 times
    daily).
    • Sodium ipodate (500 mg per day orally) will restore serum T3
    levels to normal in 48–72 hours
    • This is a radiographic contrast medium that not only inhibits the
    release of thyroid hormones but also reduces the conversion of
    T4 to T3, and is therefore more effective than potassium iodide
    or Lugol’s solution
    Management (cont):
    • Dexamethasone (2 mg 4 times daily) and amiodarone have similar
    effects.
    • Oral carbimazole 40–60 mg daily should be given to inhibit the synthesis
    of new thyroid hormone.
    • If the patient is unconscious or uncooperative, carbimazole can be
    administered rectally with good effect but no preparation is available for
    parenteral use.
    • After 10–14 days the patient can usually be maintained on carbimazole
    alone.
    Complication

    Complications of thyroid storm include:

    • High output cardiac failure


    • Cardiac arrhythmias
    • Delirium, seizures, coma
    • Abdominal pain, diarrhea, vomiting, jaundice
    • Elevation of transaminases

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