Thyroid storm: an updated review.
Thyroid storm, an endocrine emergency first described in 1926, remains a diagnostic and therapeutic challenge. No laboratory abnormalities are specific to thyroid storm, and the available scoring system is based on the clinical criteria. The exact mechanisms underlying the development of thyroid storm from uncomplicated hyperthyroidism are not well understood. A heightened response to thyroid hormone is often incriminated along with increased or abrupt availability of free hormones. Patients exhibit exaggerated signs and symptoms of hyperthyroidism and varying degrees of organ decompensation. Treatment should be initiated promptly targeting all steps of thyroid hormone formation, release, and action. Patients who fail medical therapy should be treated with therapeutic plasma exchange or thyroidectomy. The mortality of thyroid storm is currently reported at 10%. Patients who have survived thyroid storm should receive definite therapy for their underlying hyperthyroidism to avoid any recurrence of this potentially fatal condition.
Division of Endocrinology and Metabolism, Department of Medicine, Loyola University Medical Center, Maywood, IL, USA.
Maguy
M
Chiha
Division of Endocrinology and Metabolism, Department of Medicine, Loyola University Medical Center, Maywood, IL, USA.
Shanika
S
Samarasinghe
Section of Endocrine Surgery, Department of Surgery, Loyola University Medical Center, Maywood, IL, USA akabaker@lumc.edu.
Adam S
AS
Kabaker
D006801:Humans; D006980:Hyperthyroidism / Q000150:complications*; D013958:Thyroid Crisis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy
hyperthyroidism; therapeutic plasma exchange; thyroid crisis; thyroid storm; thyrotoxicosis