Thyroid storm is a life-threatening exacerbation of hyperthyroidism. It is characterized by fever, tachycardia, diarrhea, weight loss, and other symptoms. Treatment involves administering fluids, antibiotics if infection is present, beta blockers to reduce sympathetic stimulation, anti-thyroid drugs to block hormone synthesis, corticosteroids, and monitoring vital signs and hormone levels. Early and aggressive management is needed but mortality remains at 10% despite treatment.

1. ALIYARAHMAN

2.  Acute exaggeration of thyrotoxicosis leading
to diarrhoea, weight loos, fever, tachycardia,
arrythmias, profuse sweating, confusion,
agitation, dehydration and peripheral
circulatory failure.
 It is a medical emergency and mortality is
10% inspite of early management.

3.  Acute precipitation of unrecognised or
untreated hyperthyroidsm by infection, stroke
and trauma
 Following surgery.
 Following acute radiational damage by I131

4.  FLUIDS: plenty of fluids and saline to correct
dehydration and hypotension
 ANTIBIOTICS: broad spectrum antibiotics to
treat infections.
 BETA BLOCKERS: propanolol (60-8-mg/8
hourly or 1-5mg/6hourly iv) – overcome
sympathetic stimulation
 IODINE THERAPY : lugol iodide given 1 hour
after anti thyroid to block thyroid hormone
synthesis.
 Anti thyroid drugs : carbimazole (15-
20mg/8hour) or propylthiouracil (600mg
loading dose followed by 200-300mg/6horly)

5.  CORTICOSTEROIDS : DEXAMETHESONE
2mg/6hour IV and dopamine infusion to treat
shock
 Digitalis for atrial fibrillation
 Monitor pulse, BP, ECG, electrolytes and
hormone levels.

6.  Monitor vitals i/o neurological and
cardiovascular status.
 Establish IV line for drugs and fluids
 Administer anti thyroid drugs as ordered
 Lower body temperature buy cold baths,
external cooling or by drugs
 Supportive oxygen therapy as needed