Thyroid storm after chest trauma

Tatjana Novaković ,
Tatjana Novaković
Bogdan Dejanović ,
Bogdan Dejanović
Zdravko Vitošević ,
Zdravko Vitošević
Nenad Milošević ,
Nenad Milošević
Jovana Milošević ,
Jovana Milošević
Ljiljana Jovićević ,
Ljiljana Jovićević
Emilija Novaković ,
Emilija Novaković
Miloš Mirković ,
Miloš Mirković
Zlatica Mirković
Zlatica Mirković

Published: 01.12.2019.

Volume 49, Issue 3 (2020)

pp. 51-54;

https://doi.org/10.5937/pramed2004051n

Abstract

Thyroid storm is an acute and severe complication of thyrotoxicosis. It is characterized by high fever, sweating, tachycardia, and often heart failure too. The objectives of the paper is to present the case of a patient with thyroid storm developed after the trauma of the chest at previously apparently healthy individuals, diagnosed on the basis of clinical preview and based on the diagnostic criteria according to Burch and Wartofsky. The most common complication is Mb. Graves - Basedow, but often associated with multi-nodose goiter. Thyroid storm is the most severe form of thyrotoxicosis with a mortality rate of 8 to 25 %. Case report. We present an interesting case from our practice: thyroid storm caused after chest trauma in apparently healthy people, but with unrecognized hyperthyroidism and thyroid gland nodule. Conclusion. The objectives of this presentation were to raise awareness of the association between signs and symptoms of thyroid storm that dominate the clinical picture and complicate the initial presentation and the evolution of the situation caused by trauma. The treatment of hyperthyroidism resulted in conversion in sinus rhythm, withdrawal of symptoms and signs heart failure, and normalization of artery pressure.

References

1.
Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, et al. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Vol. 26, Thyroid. 2016. p. 1343–421.
2.
Wartofsky L. Thyrotoxic storm. In 2005. p. 651–7.
3.
Akamizu T, Satoh T, Isozaki O, Suzuki A, Wakino S, Iburi T, et al. Diagnostic Criteria, Clinical Features, and Incidence of Thyroid Storm Based on Nationwide Surveys. Vol. 22, Thyroid. 2012. p. 661–79.
4.
Klein I, Danzi S. Thyroid Disease and the Heart. Vol. 116, Circulation. 2007. p. 1725–35.
5.
Angell TE, Lechner MG, Nguyen CT, Salvato VL, Nicoloff JT, LoPresti JS. Clinical Features and Hospital Outcomes in Thyroid Storm: A Retrospective Cohort Study. Vol. 100, The Journal of Clinical Endocrinology & Metabolism. 2015. p. 451–9.
6.
CHAN JJS, LADENSON PW. Discordant Hypothyroxinemia and Hypertriiodothyroninemia in Treated Patients with Hyperthyroid Graves’ Disease. Vol. 63, The Journal of Clinical Endocrinology & Metabolism. 1986. p. 102–6.
7.
A. A, AK S, MG K. Changes in thyroid hormones in surgical trauma. Vol. 38. 1992. p. 117–8.
8.
Delikoukos S, Mantzos F. Thyroid Storm Induced by Blunt Thyroid Gland Trauma. Vol. 73, The American Surgeon. 2007. p. 1247–9.
9.
Hagiwara A, Murata A, Matsuda T, Sakaki S, Shimazaki S. Thyroid Storm After Blunt Thyroid Injury: A Case Report. Vol. 63, Journal of Trauma: Injury, Infection & Critical Care. 2007. p. E85–7.
10.
THOMAS FB. Apathetic Thyrotoxicosis: A Distinctive Clinical and Laboratory Entity. Vol. 72, Annals of Internal Medicine. 1970. p. 679.
11.
GHOBRIAL MW, RUBY EB. Coma and Thyroid Storm in Apathetic Thyrotoxicosis. Vol. 95, Southern Medical Journal. 2002. p. 552–4.
12.
Sarlis NJ, Gourgiotis L. Vol. 4, Reviews in Endocrine and Metabolic Disorders. 2003. p. 129–36.
13.
De Leo S, Lee SY, Braverman LE. Hyperthyroidism. Vol. 388, The Lancet. 2016. p. 906–18.
14.
Satoh T, Isozaki O, Suzuki A, Wakino S, Iburi T, Tsuboi K, et al. 2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition). Vol. 63, Endocrine Journal. 2016. p. 1025–64.
15.
Sabnis G, Karnik N, Chavan S, Korivi D. Recurrent pyogenic meningitis in a 17-year-old: A delayed presentation of X-linked agammaglobulinemia with growth hormone deficiency. Vol. 59, Neurology India. 2011. p. 435.
16.
Wilkinson JN. Thyroid storm in a polytrauma patient. Vol. 63, Anaesthesia. 2008. p. 1001–5.

Citation

Copyright

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Most read articles

Indexed by