[Thyrotoxic crisis. Pitfalls in diagnosis--intensive therapy]

Thyroid storm--a dramatic exacerbation of existing hyperthyroidism of sudden onset associated with hyperthermia, tachycardia and CNS symptomatology--remains a life-threatening disease. On account of an overlapping of the symptoms of precipitating conditions, and complications, e.g. thromboembolism, the clinical diagnosis is not easy, and is often established "too late'. Since an additional role is often played by exposure to iodine, treatment is also rendered more difficult, for antithyroid drugs inhibit only de novo synthesis, but not the secretion of stored thyroxin. Treatment requires the use of thyroid-specific and numerous adjuvant measures, and the patient must be admitted to an intensive care unit with relevant experience.