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Thyroid storm presenting with coma.

J R L McLean1, K Allan1

  • 1Department of Anaesthesia and Intensive Care Norfolk and Norwich University Hospital Norwich UK.

Anaesthesia Reports
|November 22, 2021
PubMed
Summary
This summary is machine-generated.

Thyroid storm is a rare condition causing severe thyrotoxicosis. This case shows a patient recovering from coma due to thyroid storm, emphasizing early diagnosis in critical illness.

Keywords:
diagnosis, hyperthyroidismhyperthyroidismsigns, thyrotoxicosistreatment

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Area of Science:

  • Endocrinology
  • Critical Care Medicine
  • Neurology

Background:

  • Thyroid storm, a severe form of thyrotoxicosis, is uncommon, especially with coma.
  • Patients with thyrotoxicosis often present with non-specific symptoms, complicating diagnosis.

Observation:

  • A 32-year-old woman presented in a coma with tachycardia, hypertension, and pyrexia.
  • Initial investigations, including cerebrospinal fluid analysis, were inconclusive, and she required vasopressors for hypotension.
  • Thyroid function tests revealed suppressed thyroid-stimulating hormone with elevated thyroxine and triiodothyronine levels.

Findings:

  • The patient was diagnosed with thyroid storm based on clinical presentation and laboratory results.
  • Treatment focused on managing thyrotoxicosis, leading to a significant improvement in her condition.

Implications:

  • This case underscores the critical importance of considering thyroid storm in critically ill patients with unexplained coma and non-specific symptoms.
  • Early recognition and treatment of thyroid storm can lead to favorable outcomes, even in atypical presentations.
  • Highlights the need for comprehensive diagnostic workups in intensive care settings to include endocrine emergencies.