EndocrinologyTier 1Disease (DEADMAN)

Acute metabolic derangements - thyroid storm

Description

  • *Decompensated thyrotoxicosis with end-organ failure* - a clinical diagnosis, not a biochemical one
  • *The thyroid function tests are NO different from uncomplicated thyrotoxicosis - do not wait for them, and do not be reassured by them*
  • The triad that defines decompensation
    • HYPERTHERMIA (>38.5, often >40 degrees C) - disproportionate to any infection
    • CARDIOVASCULAR collapse - tachycardia >140, AF, high-output heart failure, shock
    • CNS disturbance - agitation, delirium, seizures, coma
  • Plus GI-hepatic dysfunction: nausea, vomiting, diarrhoea, abdominal pain, JAUNDICE (jaundice is an ominous sign)

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