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3.12.4 - Thyroid Emergencies

from Section 3.12 - Endocrine Disorders

Published online by Cambridge University Press:  27 July 2023

By
Sridhar Nallapareddy  and
Justin Ang
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Severe hyperthyroidism or hypothyroidism should be identified and treated on clinical grounds, as laboratory tests are often delayed.

  2. 2. Always look for a trigger (e.g. infection, myocardial infarction).

  3. 3. When treating hypothyroidism, it is essential to consider if treatment of concomitant adrenal insufficiency is required.

  4. 4. Always give propylthiouracil at least 1 hour before iodides.

  5. 5. Avoid aspirin in hyperthyroid states.

Keywords

thyrotoxic stormthyrotoxicosismyxoedema comadiagnosismanagement
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 387 - 390
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Akamizu, T, Satoh, T, Isozaki, O, et al.; Japan Thyroid Association. Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys. Thyroid 2012;22:661–79.CrossRefGoogle ScholarPubMed
Burch, HB, Wartofsky, L. Life-threatening thyrotoxicosis. Thyrotoxic storm. Endocrinol Metab Clin North Am 1993;22:263–77.CrossRefGoogle ScholarPubMed
Nayak, B, Burman, K. Thyrotoxicosis and thyroid storm. Endocrinol Metab Clin North Am 2006;35:663–86, vii.CrossRefGoogle ScholarPubMed

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