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Simultaneous presentation of thyroid storm and diabetic ketoacidosis in a previously healthy 21-year-old man
  1. David Wallington1,
  2. Mark Schauer1 and
  3. Laura D Bauler2
  1. 1 Department of Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, Michigan, USA
  2. 2 Department of Biomedical Sciences, Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA
  1. Correspondence to Dr Laura D Bauler, laura.bauler{at}


A 21-year-old young man with no history of diabetes or thyroid disease presented to the emergency department with simultaneous thyroid storm and diabetic ketoacidosis. Notable findings on admission were a ventricular rate of 235 beats/min, tachypnoea, tremors, polydipsia and a lack of fever. Due to the unusual constellation of symptoms, diagnosis was only possible after initial laboratory results came back. While the lack of fever is unusual in thyroid storm, diabetic ketoacidosis has previously been reported to suppress fever, and this case supports the occurrence of this phenomenon. This case was highly unusual because the patient had not previously been diagnosed with either type 1 diabetes or Graves’ disease.

  • diabetes
  • thyroid disease
  • hyperthyroidism

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  • Contributors MS was involved in the care of this patient. DW wrote the initial manuscript. All authors discussed and identified the message and importance of this case and also contributed to the editing and revision.

  • 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.

  • Patient consent Obtained.

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