THYROID STORM

A patient aged 35 years, brought to the Emergency at 1.00am with 101F fever with pulse 148/minute. The patient was in great confusion and in delirious state. He was sweating a lot and severely anxious & irritable. He is a k/c/o Hyperthyroidism & is on treatment. ECG is normal. The most likely diagnosis is: 1) Acute Angina Attack 2) SABE 3) Diabetic Coma 4) Thyroid Storm or Crisis

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Thyroid storm, also referred to as thyrotoxic crisis, is an acute, life-threatening, hypermetabolic state induced by excessive release of thyroid hormones (THs) in individuals with thyrotoxicosis. Thyroid storm may be the initial presentation of thyrotoxicosis in undiagnosed children, particularly in neonates. The clinical presentation includes fever, tachycardia, hypertension, and neurological and GI abnormalities. Hypertension may be followed by congestive heart failure that is associated with hypotension and shock. Because thyroid storm is almost invariably fatal if left untreated, rapid diagnosis and aggressive treatment are critical. Fortunately, this condition is extremely rare in children. Diagnosis is primarily clinical, and no specific laboratory tests are available. Several factors may precipitate the progression of thyrotoxicosis to thyroid storm. In the past, thyroid storm was commonly observed during thyroid surgery, especially in older children and adults, but improved preoperative management has markedly decreased the incidence of this complication. Today, thyroid storm occurs more commonly as a medical crisis rather than a surgical crisis.
Dear Dr Gunjesh Kumar, The answer is clasdical presentation of Thyroid Storm or Crisis. Answer is D Regards, Dr Sepuri Krishna Mohan
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