[Thyroid storm associated with multiorganic dysfunction].

Area of Science:

• Endocrinology
• Critical Care Medicine
• Internal Medicine

Background:

• Thyroid storm is a life-threatening endocrine emergency.
• Multiorgan dysfunction is an uncommon but severe complication of thyroid storm.
• Early recognition and management are crucial for patient outcomes.

Observation:

• A 36-year-old woman with undiagnosed Graves' disease presented with thyroid storm.
• The patient exhibited a high Burch and Wartofsky score (50/140).
• Clinical presentation included acute liver failure, kidney injury, lactic acidosis, heart failure, cytopenia, coagulopathy, and rhabdomyolysis.

Findings:

• Severe multiorgan dysfunction occurred in the context of thyroid storm.
• The patient's condition improved significantly with steroids, cyclophosphamide, and plasma exchange.
• These interventions were initiated prior to definitive surgical management (thyroidectomy).

Implications:

• This case highlights the potential for severe, multi-systemic complications in thyroid storm.
• Non-surgical interventions can be effective in managing critical thyroid storm with multiorgan failure.
• Physicians must consider varied presentations and alternative therapies when conventional treatments fail or are contraindicated.