What is thyroid storm and how is it treated?
Thyroid storm is a hypermetabolic and
sympathetic cri-sis caused by a sudden surge in thyroid hormones. Triggers of
thyroid storm include infection, surgery, and pain. Thyroid storm presents with
hypertension, tachycardia, and hyperthermia, and is easily confused with
malignant hyperthermia and pheochromocytoma. However, the profound metabolic
acidosis that occurs in malignant hyperthermia does not occur during thyroid
storm and plays an important role in differentiating between the two disorders.
The immediate treatment of thyroid storm is the
administration of β-blockade agents to alleviate the symp-toms.
Hyperthermic patients should be actively cooled. There are case reports of
effective treatment of thyroid storm with dantrolene; however, this is not
routinely recommended at this time. After initial control of the symptoms, the
patient should receive PTU and potassium iodide.
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