Thyroid storm precipitated by trauma

doi:10.1016/S0736-4679(96)00178-3

The Journal of Emergency Medicine

Volume 14, Issue 6, November–December 1996, Pages 697-701

https://doi.org/10.1016/S0736-4679(96)00178-3 Get rights and content

Abstract

A 21-year-old woman presented to the emergency department complaining of head, neck, and abdominal pain after being assaulted. She denied a previous history or significant symptoms of hyperthyroidism. The physical examination was remarkable for lethargy, low-grade fever, tachycardia, facial abrasions, swelling of the anterior neck, and a tremor. A diagnosis of thyroid storm was made. An extensive work up excluded other causes of the patient's tachycardia, altered mental status, and neck swelling. A review of the clinical features and management of thyroid storm is presented. Relatively minor trauma can be a precipitating event for thyroid storm.

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Cited by (33)

Thyroid Storm in a Patient with Trauma – A Challenging Diagnosis for the Emergency Physician: Case Report and Literature Review
2017, Journal of Emergency Medicine
Citation Excerpt :
We conducted a brief review of the available literature, discussing the etiology, clinical presentation, diagnosis, treatment, and outcome of patients with posttraumatic thyroid storm. After a brief review of the literature, we found 22 articles reporting cases of posttraumatic thyroid storm, which was first described by Jacobs in 1979 (5,8–28). For one article written in German, we used only the data reported in the abstract (12).
Thyroid storm, an endocrine emergency, remains a diagnostic and therapeutic challenge. It is recognized to develop as a result of several factors, including infection, surgery, acute illness, and rarely, trauma. Recognition of thyroid storm in a trauma patient is difficult because the emergency physician usually focuses on managing more obvious injuries.
We present a case of trauma-related thyroid storm and review the previous literature on posttraumatic thyroid storm to delineate risk factors of the disease. The case occurred in a 32-year-old man after a motorcycle accident.
Careful investigation of patient history and risk factors of trauma-related thyroid storms and utilization of the scoring system may facilitate early diagnosis. Traumatically induced thyroid storm usually responds to medical treatment developed for hyperthyroidism. Surgical intervention may be needed for patients who failed medical treatment or those with direct thyroid gland injuries. The outcome is usually fair under appropriate management.
We present a case of trauma-related thyroid storm to illustrate the diagnostic and therapeutic approach with a summary of the previous literature. Emergency physicians should be aware of the clinical presentation and risk factors of patients with trauma-related thyroid storm to reduce the rate of misdiagnosis and prevent catastrophic outcomes.
Thyroid crisis in the maxillofacial trauma patient
2014, Journal of Oral and Maxillofacial Surgery
Thyroid crisis, also known as thyroid storm, is a rare complication of thyrotoxicosis that results in a hypermetabolic and hyperadrenergic state. This condition requires prompt recognition and treatment because the mortality from thyroid crisis approaches 30%. Thyrotoxicosis alone will usually not progress to thyroid crisis. Thyroid crisis will typically be precipitated by some concomitant event such as infection, iodine-containing contrast agents, medications such as amiodarone, pregnancy, or surgery. Trauma is a rare precipitator of thyroid crisis. Several published studies have reported thyroid crisis resulting from blunt or penetrating neck trauma. Significant systemic trauma, such as motor vehicle accidents, has also been reported to precipitate thyroid crisis. It is very unusual for minor trauma to precipitate thyroid crisis. In the present study, we report the case of a patient who had incurred relatively minor maxillofacial trauma and developed thyroid crisis 2 weeks after the initial trauma.
Thyroid Disorders
2008, Critical Care Medicine: Principles of Diagnosis and Management in the Adult
Thyrotoxicosis
2008, Pediatric Emergency Medicine
Thyrotoxicosis
2007, Pediatric Emergency Medicine
Thyroid storm as a cause of unexplained tachycardia in acutely injured trauma patients
2005, Injury Extra

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^☆: Clinical Communications (Adults) is coordinated by Ron M. Walls, md, of Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

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Clinical communicationThyroid storm precipitated by trauma☆

Abstract

Med Clin North Am

Ann Fr Anesth Réanim

Injury

Ann Emerg Med

Med Clin North Am

Ann Emerg Med

Endocrinol Metab Clin North Am

Am J Emerg Med

Hyperthyroidism

Clinical communication
Thyroid storm precipitated by trauma☆