Khurana Kashish, Kumar Sunil, Acharya Sourya, Toshniwal Saket, Pantbalekundri Nikhil
Department of Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND.
Department of Internal Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research (Deemed to be University), Wardha, IND.
Cureus. 2023 May 27;15(5):e39584. doi: 10.7759/cureus.39584. eCollection 2023 May.
A 65-year-old man presented to the emergency medicine department with altered sensorium, a high-grade fever, and shock. On routine workup, he was diagnosed with acute respiratory distress syndrome with sepsis. Later, it was found that the patient had undetectable serum thyroid stimulating hormone and high triiodothyronine (T3) levels, which were diagnosed as a thyroid storm. This highlights the fact that a thyroid storm can present in any way and should be considered when determining the cause of septic shock that is not responding to standard treatment. A rare endocrine emergency, thyroid storm is a life-threatening endocrinological emergency with a considerable death rate of between 10% and 30% and multi-organ failure. It happens in thyrotoxic patients and manifests as the decompensation of several organs brought on by extreme stress. In addition to shock, the patient also had altered sensory perception, a cough, a fever, palpitations, and a sore throat. The patient was initially diagnosed with septic shock and was later treated with oral carbimazole, higher antibiotics, inotropes, and propranolol.
一名65岁男性因意识改变、高热和休克被送往急诊科。在常规检查中，他被诊断为脓毒症伴急性呼吸窘迫综合征。后来发现该患者血清促甲状腺激素检测不到，三碘甲状腺原氨酸（T3）水平升高，被诊断为甲状腺危象。这凸显了一个事实，即甲状腺危象可以以任何形式出现，在确定对标准治疗无反应的感染性休克病因时应予以考虑。甲状腺危象是一种罕见的内分泌急症，是一种危及生命的内分泌急症，死亡率在10%至30%之间，常伴有多器官功能衰竭。它发生在甲状腺毒症患者中，表现为极端应激导致的多个器官失代偿。除了休克，患者还出现了感觉异常、咳嗽、发热、心悸和喉咙痛。患者最初被诊断为感染性休克，后来接受了口服卡比马唑、更强效的抗生素、血管活性药物和普萘洛尔治疗。
