[Thyroid emergencies : Thyroid storm and myxedema coma]

Area of Science:

• Endocrinology
• Emergency Medicine

Background:

• Thyroid emergencies are rare, life-threatening endocrine conditions.
• They arise from decompensated thyrotoxicosis (thyroid storm) or severe thyroid hormone deficiency (myxedema coma).
• These conditions often develop from long-standing, undiagnosed, or untreated hyperthyroidism or hypothyroidism, precipitated by acute stress.

Purpose of the Study:

• To summarize the clinical presentation, diagnosis, and management of thyroid emergencies.
• To highlight the importance of early clinical recognition and prompt multimodal therapy.

Main Methods:

• Review of cardinal clinical features for thyroid storm and myxedema coma.
• Discussion of diagnostic criteria, emphasizing clinical assessment over hormone levels.
• Outline of therapeutic strategies, including critical care, hormone modulation, and supportive measures.

Main Results:

• Thyroid storm presents with hyperthermia, tachycardia, and central nervous system dysfunction.
• Myxedema coma is characterized by hypothermia, altered mental status, and hypoventilation.
• Diagnosis for both is primarily clinical, as hormone levels do not distinguish emergency from uncomplicated states.

Conclusions:

• Optimal survival in thyroid emergencies depends on early clinical diagnosis.
• Prompt initiation of multimodal therapy, including supportive care and addressing precipitating factors, is essential.