Tuesday 26 October 2010

MRCP revision battle 35.5: Thyroid storm

Thyroid storms may be precipitated by:
  • 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..'