Not just gastroenteritis: thyroid storm unmasked.
Establishing the diagnosis of thyroid storm is difficult in the ED, especially where there is no antecedent history of thyroid disease or clinical clues like goitre, exophthalmos or altered mentation, yet early recognition and treatment are essential in reducing mortality and morbidity from this endocrine emergency. We present a case where suspected infective gastroenteritis in a newly diagnosed diabetic masked the major symptomatology of thyroid storm, and review the diagnosis and management of thyrotoxic crisis.
Charles
Rabind Antony
RA
Department of Emergency Medicine, Singapore General Hospital, Singapore Health Services, Singapore. rabindcharles@yahoo.com.sg
Goh
Su-Yen
SY
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D013956:Antithyroid Agents / Q000627:therapeutic use; D023341:Chills / Q000209:etiology; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000188:drug therapy; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000209:etiology; D004635:Emergency Medicine / Q000379:methods*; D005260:Female; D005334:Fever / Q000209:etiology; D005759:Gastroenteritis / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007328:Insulin / Q000627:therapeutic use; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use; D011441:Propylthiouracil / Q000627:therapeutic use; D013610:Tachycardia / Q000188:drug therapy / Q000209:etiology; D013958:Thyroid Crisis / Q000175:diagnosis* / Q000188:drug therapy
D000889:Anti-Arrhythmia Agents; D013956:Antithyroid Agents; D007328:Insulin; D011441:Propylthiouracil; D011433:Propranolol