What is the definition of Thyroid Storm?

Thyroid storm is a very rare, but life-threatening condition of the thyroid gland that develops in cases of untreated thyrotoxicosis (hyperthyroidism, or overactive thyroid).

The thyroid gland is located in the neck, just above where your collarbones meet in the middle.

What are the alternative names for Thyroid Storm?

Thyrotoxic storm; Thyrotoxic crisis; Hyperthyroid storm; Accelerated hyperthyroidism; Thyroid crisis; Thyrotoxicosis - thyroid storm

What are the causes for Thyroid Storm?

Thyroid storm occurs due to a major stress such as trauma, heart attack, or infection in people with uncontrolled hyperthyroidism. In rare cases, thyroid storm can be caused by treatment of hyperthyroidism with radioactive iodine therapy for Graves disease. This can occur even a week or more after the radioactive iodine treatment.

What are the symptoms for Thyroid Storm?

Symptoms are severe and may include any of the following:

  • Agitation
  • Change in alertness (consciousness)
  • Confusion
  • Diarrhea
  • Increased temperature
  • Pounding heart (tachycardia)
  • Restlessness
  • Shaking
  • Sweating
  • Bulging eyeballs

What are the current treatments for Thyroid Storm?

Thyroid storm is life-threatening and requires emergency treatment. Often, the person needs to be admitted to the intensive care unit. Treatment includes supportive measures, such as giving oxygen and fluids in case of breathing difficulty or dehydration. Treatment may include:

  • Cooling blankets to return the body temperature to normal
  • Monitoring any excess fluid in older people with heart or kidney disease
  • Medicines to manage agitation
  • Medicine to slow the heart rate
  • Vitamins and glucose

The final goal of treatment is to decrease the levels of thyroid hormones in the blood. Sometimes, iodine is given in high doses to try and stun the thyroid. Other drugs may be given to lower the hormone level in the blood. Beta blocker medicines are often given by vein (IV) to slow the heart rate, lower blood pressure, and block the effects of the thyroid hormone excess.

Antibiotics are given in case of infection.

What are the possible complications for Thyroid Storm?

Irregular heart rhythms (arrhythmias) may occur. Heart failure and pulmonary edema can develop rapidly and cause death.

When should I contact a medical professional for Thyroid Storm?

This is an emergency condition. Call 911 or another emergency number if you have hyperthyroidism and experience symptoms of thyroid storm.

How do I prevent Thyroid Storm?

To prevent thyroid storm, hyperthyroidism should be treated.

Thyroid

REFERENCES

Jonklaas J, Cooper DS. Thyroid. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 213.

Marino M, Vitti P, Chiovato L. Graves' disease. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 82.

Tallini G, Giordano TJ. Thyroid gland. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL, eds. Rosai and Ackerman's Surgical Pathology. 11th ed. Philadelphia, PA: Elsevier; 2018:chap 8.

Thiessen MEW. Thyroid and adrenal disorders. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 120.

  • Condition: Thyroid Storm
  • Journal: Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
  • Treatment Used: Therapeutic Plasma Exchange Combined with Total Thyroidectomy
  • Number of Patients: 1
  • Published —
In this study, researchers evaluated the outcomes of using a combination of plasma exchange and thyroidectomy for the treatment of a thyroid storm.
  • Condition: Mental Health Related Thyroid Crisis
  • Journal: BMJ case reports
  • Treatment Used: Intramuscular Levothyroxine
  • Number of Patients: 1
  • Published —
This article reported on a patient with thyroid storm and severe behavioral problems treated with parenteral levothyroxine.

There are no recent clinical trials available for this condition. Please check back because new trials are being conducted frequently.