ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 EP157 | DOI: 10.1530/endoabs.63.EP157

Thyroid storm, a rare but life-threatening appearance of hyperthyroidism

Megi Lekbello, Violeta Hoxha, Gerond Husi, Thanas Fureraj, Ermira Duva & Agron Ylli

Mother Theresa Hospital, Tirana, Albania.

Thyrotoxicosis is characterised by the excess of thyroid hormones into blood. The most extreme appearance of it, is thyroid storm which is presented as an acute, severe, life-threatening, hypermetabolic state caused by the added quantities of thyroid hormones, causing adrenergic hyperactivity and abnormal periphery response of thyroid hormones. The incidence of thyroid storm is evaluated at 0.2/100000 in year. The mortality of untreated thyroid storm varies from 80–100% while treated one is 10–50%. The main cause of death is the multiorgan failure followed by cardiac failure, respiratory failure, arrhythmia, disseminated intravascular coagulation, hypoxic syndrome of brain and sepsis. Thyroid storm causes are related to endocrine disorders with primary or secondary origin. In rare cases it can be caused from exogenous pathology or drugs. The diagnosis is made based on Burch-Wartofsky score. The treatment is multidimensional and aims the most effective treatment possible of thyroid storm. In Endocrinology, Diabetes and Metabolic Diseases clinic in ‘Mother Teresa’ University Hospital Centre during the last year are hospitalised 5 patients, all females, with signs of thyroid storm crisis. All patients presented with fever, vomiting, abdominal pain and confusion. In two cases thyroid storm was precipitated by surgery, two cases from severe infection and in one patient by radioactive iodine therapy. Treatment was initiated immediately and fortunately we had zero mortality rate. Being a rare phenomenon and with a high mortality it is important to study the thyroid storm and its management.

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