Thyroid storm is a rare and sudden onset condition that occurs when thyroid hormones levels in the body jump dramatically. This is an extremely serious condition that warrants immediate medical care. Failure to treat thyroid storm usually means the condition is fatal quickly. However, symptoms are so grave, they are unlikely to be ignored.
Having too much of thyroid hormone can occur in several types of disease. It sometimes happens as a consequence of thyroid surgery but more commonly occurs in present day due to underlying conditions like Grave’s disease, which causes elevated thyroid levels at a slower pace. Sometimes other diseases such as Hashimoto’s thyroiditis are also responsible for a sudden thyroid storm, though this autoimmune disorder is more commonly associated with below normal thyroid hormone levels. Other conditions that have been associated with “storm” include lupus, goiter or tumors on the thyroid.
Many symptoms can present with thyroid storm. These include fever, usually of at least 101.3 degrees F (38.5 C) or higher. In many cases, fever is at least or higher than 105.8 degrees F (41 C). Sweating and difficulty breathing may be noted too. Nausea or vomiting can occur, and other stomach symptoms like diarrhea could be present. Jaundice or yellowing of the skin and whites of the eyes is sometimes present too. Behavior could change and people could be anxious or altered, and they might exhibit a visible tremor or shakiness.
On examination of the heart, heart rate is usually much quicker than normal and may exhibit sudden arrhythmia. Initially blood pressure may be elevated, but as thyroid storm progresses it can become too low (hypotensive). The longer this illness is allowed to progress the greater the potential damage. Seizures often develop and without treatment, people will ultimately lapse into a coma and die.
Given the mortality rate of untreated thyroid storm, emphasis is on treating right away, and also making sure that people with certain illnesses like Graves are aware of its potential to occur. As with any form of hyperthyroid disorder, most common treatment is to give medications to stop thyroid production, and these may vary. Other medical support could be needed, including administration of fluids to help with fluid loss due to high body temperature or vomiting and diarrhea. Fever may need to be brought down too with cooling packs or ice. Cardiac stability might require continued assessment
Once stability is achieved, patients may be released from the hospital, but they will usually need to follow up with an endocrinologist. Release could be delayed by necessity of treating underlying conditions or causes. Outlook tends to be good for those who get early treatment, though they may need additional inpatient or outpatient treatment to prevent recurrence of a thyroid storm.
