The information on this website is not intended for diagnosis or treatment. Please consult your physician for health concerns.

+90 850 321 50 00

Thyrotoxic Crisis (Thyroid Storm)

A life-threatening severe hyperthyroid emergency.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is Thyrotoxic Crisis (Thyroid Storm)?

Thyrotoxic crisis (thyroid storm) is the acute decompensation of untreated or poorly treated hyperthyroidism. Mortality is 10–30% even with treatment. Triggers include infection, surgery, trauma, radioactive iodine therapy and discontinuation of antithyroid drugs.

The Burch–Wartofsky score is used in diagnosis: fever, central nervous system effects (agitation, delirium, coma), gastrointestinal findings (diarrhoea, jaundice) and cardiovascular findings (tachycardia, atrial fibrillation, heart failure) are scored.

Treatment is multimodal: inhibition of thyroid hormone synthesis (propylthiouracil), blockade of peripheral T4→T3 conversion, beta-blockade, corticosteroids, supportive care and treatment of the trigger are applied together.

Symptoms

High fever (>39°C)
Severe tachycardia (>140/min)
Agitation, confusion and coma
Profuse sweating
Nausea, vomiting, diarrhoea and jaundice
Heart failure and atrial fibrillation

Risk Factors

Untreated Graves' disease
Sudden cessation of antithyroid drugs
Administration of iodinated contrast media
Surgery or trauma in a hyperthyroid patient
Infection

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If high fever and tachycardia develop in known hyperthyroidism (emergency)
  • If altered mental status and agitation are present (emergency)
  • If severe symptoms begin after antithyroid drugs are stopped
  • If signs of heart failure are rapidly worsening

Treatment Methods

01
PTU (propylthiouracil) — high dose (also inhibits peripheral conversion)
02
Iodine (1 hour after PTU — Wolff–Chaikoff effect)
03
Propranolol (high dose — beta-blockade plus T4→T3 inhibition)
04
IV hydrocortisone (adrenal insufficiency cover and conversion inhibition)
05
Cooling and fluid resuscitation
06
Treatment of the trigger (antibiotics etc.)

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Endokrinoloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

Book AppointmentContact Us

Related Health Topics

Other articles from the same department you may want to explore.

Thyroid Nodule Evaluation

Endokrinoloji

Thyroid nodules are very common and the vast majority are benign; however, fine-needle aspiration biopsy may be required based on ultrasound features for malignancy risk assessment.

Management of Graves' Disease

Endokrinoloji

Graves' disease is the most common cause of autoimmune hyperthyroidism, developing with excessive stimulation of the thyroid gland by thyroid-stimulating antibody (TRAb).

Management of Hashimoto's Thyroiditis

Endokrinoloji

Hashimoto's thyroiditis is the most common cause of hypothyroidism, due to autoimmune destruction of the thyroid gland with anti-TPO and anti-thyroglobulin antibodies.

Primary Adrenal Insufficiency (Addison's Disease)

Endokrinoloji

Addison's disease is a potentially life-threatening endocrine disorder presenting with cortisol and aldosterone deficiency due to autoimmune destruction of the adrenal glands.

Cushing Syndrome Diagnostic Workup

Endokrinoloji

Cushing syndrome is an endocrine disorder presenting with central obesity, striae, hypertension, and metabolic disturbances due to chronic glucocorticoid excess; its diagnosis is challenging.

Pheochromocytoma and Paraganglioma

Endokrinoloji

Pheochromocytomas and paragangliomas are rare tumors that secrete excess catecholamines, causing paroxysmal hypertension, headache, sweating, and palpitations.

Primary Hyperaldosteronism (Conn Syndrome)

Endokrinoloji

Primary hyperaldosteronism is a treatable cause of resistant hypertension and hypokalemia caused by excessive aldosterone secretion from the adrenal gland.

Comprehensive Evaluation of Hypopituitarism

Endokrinoloji

Hypopituitarism is a deficiency of pituitary hormone production that leads to multiple endocrine organ failures and requires lifelong hormone replacement.

Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.