Thyroid storm presenting as septic shock in the intensive care unit: A Case Series

Abstract

Thyroid storm is a rare endocrine emergency that rarely presents with septic shock. It occurs in
thyrotoxic patients and is manifested by decompensation of multiple organs, triggered by severe
stress. The diagnosis and response to treatment is made by Burch-Wartofsky point scale or Japanese
thyroid association criteria due to lack of pathophysiology of thyroid storm. We reported series of
patients that presented with altered sensorium, cough, fever, palpitation, shortness of breath and
shock. Patient were treated initially for septic shock, later diagnosed as thyroid storm and was treated
with oral carbimazole, propanolol and digoxin. From this, we want to emphasize that thyroid storm
can have any presentation that should be kept in differential diagnosis of septic shock not responding
to usual treatment; early diagnosis and treatment with oral medication can decrease morbidity and
mortality in rural setting where intravenous form of antithyroid drug are not available for thyroid
storm.