Thyroid storm

The thyroid gland is located in the front of the neck, its function is related to the synthesis of hormones, the release of which in the blood is essential for the normal function of all cells in the body.

Under certain conditions, the thyroid gland becomes more active and synthesizes and releases too much thyroid hormone, the condition is referred to as hyperthyroidism.

People with this disease face the consequences of the overactivity of a number of organs, which leads to the appearance of a number of annoying and discomforting symptoms such as sweating, hot flashes, heart palpitations, weight loss, and sometimes vision problems.

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When the levels of thyroid hormones in the blood increase too much, then the symptoms of hyperfunction of the gland are greatly aggravated and can lead to a serious illness called “thyroid” storm or thyrotoxic crisis.

One main characteristic sign of thyroid storm distinguishes it from ordinary hyperfunction of the thyroid gland and this is the significant increase in body temperature, which can be around 40.5-41.1 degrees Celsius. A Shield Storm is an uncommon but dangerous condition and when it develops it is life threatening. People with symptoms of thyroid storm should be admitted to the intensive care unit immediately.

What are the symptoms?

• Rapid heartbeat – palpitations;
• Very high body temperature;
• Chest pains;
• Shortness of breath;
• Anxiety and irritability;
• Disorientation;
• Profuse sweating;
• General muscle weakness;
• Heart failure;

What are the causes?

Thyroid storm can be considered the highest degree of hyperthyroidism and usually occurs when measures are not taken in time to normalize the function of the thyroid gland. Precipitating factors for the condition have been identified such as trauma and stress.

Other possible causes are:

• Infections, especially of the lung;
• Thyroid surgery, especially in patients with hyperfunction of the thyroid gland;
• Discontinuation of therapy with drugs prescribed for hyperfunction of the gland;
• Too high a dose of synthetic T3 and T4 hormones during hormone replacement therapy;
• Treatment with radioactive iodine;
• Pregnancy;
• Heart attack or other life-threatening heart conditions;

Treatment of thyroid storm

Treatment consists of taking timely life-support measures to ensure the maintenance of vital functions while at the same time attempts are made to the release of thyroid hormones decreased.

When the patient’s condition is stabilized, tests are ordered in an attempt to determine the cause of the condition. Treatment and supportive measures may consist of:

• Complete examination of the patient and their medical history to determine the cause of the thyroid storm.
• IV fluids and electrolytes;
• Oxygen therapy if needed;
• Management of fever with antipyretics – drugs to reduce elevated body temperature.
• Intravenous infusion of corticosteroids such as hydrocortisone;
• Medications blocking the synthesis and release of T3 and T4 hormones such as propylthiouracil or metamizole;
• Iodide to block thyrotropin or thyroid-stimulating hormone /TSH;
• Medicines called beta blockers such as propranolol block the action of thyroid hormones in the body;
• If the patient has heart failure, it must is being treated.

Prevention

Thyroid storm can be prevented by starting treatment for hyperthyroidism early and by recognizing the early symptoms of the condition.

What are the predictions for the outcome of the thyrotoxic crisis?

Thyroid storm is a very serious condition that can lead to death and prompt and intensive treatment will help improve the patient’s condition.