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nguyentrinh
06-05-10, 12:56 PM
Thyroid storm

Thyroid storm is a life-threatening condition that develops in cases of untreated thyrotoxicosis
It usually occurs in individuals with Graves' disease, it has also been reported in patients with other causes of hyperthyroidism. Thyroid storm is usually precipitated by a concurrent illness or injury, but has been reported to occur spontaneously following withdrawal of ATDs or following radioactive iodine therapy for hyperthyroidism

Causes

Thyroid storm results from untreated hyperthyroidism. It is usually brought on by a stress such as trauma or infection.

Symptoms

Symptoms are severe and may include:
• Agitation
• Change in alertness (consciousness)
• Confusion
• Diarrhea
• Fever
• Pounding heart (tachycardia
• Restlessness
• Shaking
• Sweating

Exams and Tests

• The top number in a blood pressure reading may be high
• Increased heart rate
Blood tests are done to evaluate thyroid function.
There are no specific laboratory findings distinguishing thyroid storm from uncomplicated hyperthyroidism.

Possible Complications

Congestive heart failure and pulmonary edema can develop rapidly and lead to death.

Treatment

Thus, when the diagnosis is suspected clinically, therapy must be initiated immediately.
Treatment should be initiated in the intensive care unit.
Treating the precipitating cause
Administering specific drugs such as:
(1) inhibit thyroid hormone biosynthesis (propylthiouracil or methimazole)
(2) inhibit release of thyroid hormone from the thyroid gland (eg, potassiumiodide, lithium carbonate, ipodate)
(3) decrease the peripheral effects of thyroid hormone (eg, propylthiouracil, corticosteroids, ipodate, iopanoic acid).