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Metabolic and anatomic thyroid emergencies: a review.
1Department of Clinical Physiology, Walter Reed Army Institute of Research, Washington, DC 20307-5100.
Critical Care Medicine
|February 1, 1992
Summary
This review covers intensive care for thyroid emergencies, including metabolic and anatomic conditions. Aggressive, multifaceted therapy is crucial for conditions like thyroid storm and substernal goiter.
Area of Science:
- Endocrinology
- Critical Care Medicine
- Oncology
Background:
- Thyroid diseases encompass metabolic and anatomic conditions.
- Some thyroid conditions necessitate intensive care management.
- These include thyroid storm, myxedema coma, substernal goiter, lymphoma, and anaplastic carcinoma.
Purpose of the Study:
- To review the diagnosis and management of thyroid diseases requiring intensive care.
- To outline guidelines for thyrotoxic crisis and differentiate critically ill hypothyroid patients.
- To highlight potential complications and therapeutic approaches.
Main Methods:
- A comprehensive literature search of MEDLINE and Index Medicus databases.
- Review of approximately 250 English-language articles.
- Inclusion of case reports to illustrate rare complications.
Main Results:
- Guidelines for thyrotoxic crisis etiology and hypothyroid patient differentiation are provided.
- Aggressive, multifaceted therapy is essential for critical thyroid disorders.
- Substernal goiter complications are discussed, with surgery as a primary solution.
- Thyroid lymphomas require adequate tissue for classification, with surgery playing a supportive role.
Conclusions:
- Thyroid emergencies demand multidisciplinary specialist attention.
- Management is often successful but requires further research.
- Future studies should focus on optimizing myxedema coma treatment, clarifying lymphoma therapy, and improving anaplastic carcinoma treatment.