A case of unexpected thyroid storm in postpartum

Area of Science:

• Endocrinology
• Critical Care Medicine
• Obstetrics & Gynecology

Background:

• Thyroid storm is a life-threatening endocrine emergency, often associated with Graves' disease.
• Perinatal thyroid storm is rare but poses significant risks during and after pregnancy.

Purpose of the Study:

• To report a case of postpartum thyroid storm in a patient with no prior history of thyroid disease.
• To highlight diagnostic challenges and treatment strategies for this rare condition.

Main Methods:

• Case presentation of a postpartum woman with unexplained symptoms.
• Diagnostic evaluation including thyroid hormone levels and scoring systems (Burch-Wartofsky, Japanese Thyroid Association).
• Multimodal treatment including plasmapheresis, beta-blockers, iodine, antithyroid drugs, and corticosteroids.

Main Results:

• The patient presented with symptoms mimicking intrauterine death but progressed to multi-organ failure.
• Elevated thyroid hormones confirmed thyroid storm.
• Comprehensive treatment led to successful recovery, followed by management of subsequent hypothyroidism.

Conclusions:

• Postpartum thyroid storm should be considered in women with no prior thyroid history presenting with unexplained systemic symptoms.
• Prompt diagnosis and aggressive management are crucial for favorable outcomes.
• Awareness among clinicians is essential for timely intervention in high-risk postpartum patients.