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CASE REPORT
Thyroid storm: a case of haemodynamic failure promptly reversed by aggressive medical therapy with antithyroid agents and steroid pulse
  1. Ivan Andrade Luz1,
  2. Tiago Pereira2 and
  3. Nuno Catorze2
  1. 1 Nephrology, Centro Hospitalar do Médio Tejo EPE, Unidade de Torres Novas, Torres Novas, Santarém, Portugal
  2. 2 Intensive Care Unit, Centro Hospitalar do Médio Tejo EPE, Unidade de Abrantes, Abrantes, Santarém, Portugal
  1. Correspondence to Dr Ivan Andrade Luz, iandradeluz{at}gmail.com

Abstract

Hyperthyroidism is a common metabolic disorder, although its presentation as an endocrine emergency called thyroid storm is rare. Here we review a case of a thyroid storm as the initial presentation of thyrotoxicosis, with multiple organ failure and haemodynamic collapse due to low-output cardiac dysfunction. Quick intervention with aggressive antithyroid therapy, including steroid pulse, and supportive intensive care measures led to an outstanding improvement and full recovery. The present case clearly shows the beneficial impact of initial clinical suspicion resulting in an early diagnosis and intensive therapy. Moreover, it supports the additional role of steroids to aggressive antithyroid strategy in order to control associated deleterious systemic inflammatory reactions.

  • emergency medicine
  • thyroid disease
  • drugs: endocrine system
  • medical education
  • therapeutic indications
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Footnotes

  • Patient consent for publication Obtained.

  • Contributors IAL: planning, conception, design, data analysis and interpretation, bibliographic review, case report. TP: critical revision of the article. NC: critical revision of the article, approval of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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