Thyroid storm after chest trauma

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.

[1]  S. Wakino,et al.  2016 Guidelines for the management of thyroid storm from The Japan Thyroid Association and Japan Endocrine Society (First edition). , 2016, Endocrine journal.

[2]  S. Rivkees,et al.  2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. , 2016, Thyroid : official journal of the American Thyroid Association.

[3]  J. Nicoloff,et al.  Clinical features and hospital outcomes in thyroid storm: a retrospective cohort study. , 2015, The Journal of clinical endocrinology and metabolism.

[4]  M. Mori,et al.  Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys. , 2012, Thyroid : official journal of the American Thyroid Association.

[5]  N. Karnik,et al.  Recurrent pyogenic meningitis in a 17-year-old: a delayed presentation of X-linked agammaglobulinemia with growth hormone deficiency. , 2011, Neurology India.

[6]  N. Karnik,et al.  Trauma precipitating thyroid storm. , 2011, The Journal of the Association of Physicians of India.

[7]  J. Wilkinson Thyroid storm in a polytrauma patient , 2008, Anaesthesia.

[8]  S. Delikoukos,et al.  Thyroid Storm Induced by Blunt Thyroid Gland Trauma , 2007, The American surgeon.

[9]  I. Klein,et al.  Thyroid disease and the heart. , 2007, Circulation.

[10]  A. Hagiwara,et al.  Thyroid storm after blunt thyroid injury: a case report. , 2007, The Journal of trauma.

[11]  M. Ghobrial,et al.  Coma and thyroid storm in apathetic thyrotoxicosis. , 2002, Southern medical journal.

[12]  A. Sarda,et al.  Changes in thyroid hormones in surgical trauma. , 1992, Journal of postgraduate medicine.

[13]  A. Burger,et al.  5 Thyroid emergencies , 1992 .

[14]  P. Ladenson,et al.  Discordant hypothyroxinemia and hypertriiodothyroninemia in treated patients with hyperthyroid Graves' disease. , 1986, The Journal of clinical endocrinology and metabolism.

[15]  E. Mazzaferri,et al.  Apathetic thyrotoxicosis: A distinctive clinical and laboratory entity. , 1970, Annals of internal medicine.