- recent thyroid surgery
- radioiodine
- infection
- MI
- trauma
Iatrogenic thyroxine excess doesn't usually cause a storm.
Features of a thyroid storm include:
- fever >38.5C
- tachycardia
- confusion
- nausea and vomiting
- hypertension
- heart failure
Treatment:
- treat precipitating event
- propranolol
- antithyroid drugs eg propylthiouracil or carbimazole
- dexamethasone/hydrocortisone - blocks T4 to T3
- Lugol's solution
- ?digoxin to slow heart.
Thats the end of the thyroid binge - now to 'mind the gap..'
