Open AccessRecurrent thyroid storm induced by heretofore unrecognised causes in a patient with thyroid cancer
Author(s) -
Hussein Raef,
Talal Dahhan,
Mohammed Ahmed,
Mustafa Al Mubarak,
Taquir Rana,
Asma Tulba
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.07.2008.0442
Subject(s) - thyroid storm , medicine , vomiting , nausea , thyroid cancer , thyroid , anorexia , complication , metastasis , cancer , tachycardia , surgery , radiology
An unusual encounter of a thyroid storm, on two separate occasions, is reported in a patient with metastatic differentiated thyroid cancer following initially direct trauma to, and later tumour embolisation of, a metastatic skeletal lesion. Shortly after a fall, our patient presented with pain and swelling in the right shoulder, high fever, change in mental status, anorexia, nausea and vomiting, tachycardia and dehydration. The laboratory tests were consistent with hyperthyroidism. As the patient improved, arterial embolisation of the large right humerus metastasis was performed to decrease the tumour burden. The patient, however, developed a similar clinical and biochemical picture to that at her presentation, with a very high free thyroxine (T(4)) level, a few days after successful embolisation. Treatment of the thyroid storm was initiated and the patient eventually improved. Awareness of such occurrences is helpful in early diagnosis and effective management of this potentially fatal complication.