The Case Files

    April 2014 in “ Emergency Medicine News ”
    Brett Ebeling, Stephen Rancour, Andrew King
    TLDR Thyroid storm is hard to diagnose due to vague symptoms but needs urgent attention.
    A 19-year-old man presented with symptoms suggestive of a thyroid storm, a severe form of thyrotoxicosis, characterized by nausea, vomiting, diarrhea, and abdominal pain, following a meal at a fast food restaurant. Despite a poor medical history, a review of systems revealed hair loss, weight loss, and increased thirst. Laboratory tests showed elevated free T4 and low TSH, supporting the diagnosis of thyroid storm, which was treated with IV fluids, beta-blockers, and propylthiouracil. The patient left the ICU against medical advice before further evaluation. This case highlighted the diagnostic challenges of thyroid storm, emphasizing the importance of a thorough history and review of systems, as well as the need for high clinical suspicion due to its nonspecific symptoms and potential for high mortality.
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