Endocrine Abstracts

Introduction: Thyroid storm is an acute exacerbation of hyperthyroidism, responsible for significant mortality despite treatment.

Case report: We report the observation of a 43-year-old diabetic patient with basedow’s disease with poor therapeutic adherence; admitted for convulsions and loss of consciousness. The diagnosis of acute thyroid storm on drop out of treatment was mentioned, in front of the detection of peripheral hyperthyroidism with low TSH; T4 at 67.75 pmol/l, T3 at 45 pmol/l, hepatic cytolysis and high creatine phosphokinase. Other clinical parameters included bilateral exophthalmos, vascular goiter, tachycardia at 180 beats/minute, dehydration and hyperthermia. Management consisted on intubation-ventilation, re-administration of carbimazole 50 mg and propranolol 60 mg, with bolus of corticosteroid therapy and rehydration. The patient died within 24 hours despite symptomatic intensive care measures.

Discussion/Conclusion: The thyroid storm is a rare and potentially fatal entity. Low socio-economic backgrounds promote its occurrence. The main difficulty is recognizing its varied presentations, and offering appropriate treatment when the doctor faces a failure, or against contraindications of conventional therapy.