title: A 46-Year-Old Woman With Dyspnea From an Inhalational Exposure, Triggering Thyroid Storm and Subsequent Multi-Organ System Failure.
abstract: BACKGROUND
  Thyroid storm is a rare, life-threatening condition which arises in patients with thyrotoxicosis, with an annual incidence of 2 patients per 1,000,000 and a mortality rate of 11%.
  
  
  METHODS
  We present the case of a 46-year-old-female with a medical history of controlled mild intermittent asthma, who presented with a severe asthma exacerbation, that triggered thyroid storm after exposure to polyurethane fumes.
  
  
  CONCLUSIONS
  This patient represents, to the best of our knowledge, the first patient in whom the stress related to a severe asthma attack triggered the development of thyroid storm. She also is the first patient with no indication of cardiac dysfunction who developed fatal cardiac arrest after initiation of b-blockade for treatment of thyroid storm.
authors: UMass Memorial Medical Center, Department of Pulmonary, Allergy and Critical Care, Worcester, MA, USA andrewmoraco@gmail.com.
authors: Andrew H
authors: AH
authors: Moraco
authors: UMass Memorial Medical Center, Department of Pulmonary, Allergy and Critical Care, Worcester, MA, USA.
authors: Gisela
authors: G
authors: Banauch
authors: UMass Memorial Medical Center, Department of Pulmonary, Allergy and Critical Care, Worcester, MA, USA.
authors: Scott
authors: S
authors: Kopec
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000009:adverse effects; D013956:Antithyroid Agents / Q000008:administration & dosage; D004417:Dyspnea / Q000139:chemically induced*; D017809:Fatal Outcome; D005260:Female; D006323:Heart Arrest / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects*; D008713:Methimazole / Q000008:administration & dosage; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000139:chemically induced* / Q000503:physiopathology / Q000628:therapy; D011140:Polyurethanes / Q000009:adverse effects*; D011193:Potassium Iodide / Q000008:administration & dosage; D011433:Propranolol / Q000008:administration & dosage / Q000009:adverse effects; D012151:Resuscitation; D013958:Thyroid Crisis / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology
chemical_list: D000319:Adrenergic beta-Antagonists; D013956:Antithyroid Agents; D011140:Polyurethanes; D011193:Potassium Iodide; D008713:Methimazole; D011433:Propranolol
keywords: asthma; graves disease; polyurethane fumes; thyroid storm