A 46-Year-Old Woman With Dyspnea From an Inhalational Exposure, Triggering Thyroid Storm and Subsequent Multi-Organ System Failure

J Intensive Care Med. 2015 Dec;30(8):518-20. doi: 10.1177/0885066615571527. Epub 2015 Feb 12.

Abstract

Background: Thyroid storm is a rare, life-threatening condition which arises in patients with thyrotoxicosis, with an annual incidence of 2 patients per 1,000,000 and a mortality rate of 11%.

Case: We present the case of a 46-year-old-female with a medical history of controlled mild intermittent asthma, who presented with a severe asthma exacerbation, that triggered thyroid storm after exposure to polyurethane fumes.

Conclusion: This patient represents, to the best of our knowledge, the first patient in whom the stress related to a severe asthma attack triggered the development of thyroid storm. She also is the first patient with no indication of cardiac dysfunction who developed fatal cardiac arrest after initiation of b-blockade for treatment of thyroid storm.

Keywords: asthma; graves disease; polyurethane fumes; thyroid storm.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic beta-Antagonists / administration & dosage
  • Adrenergic beta-Antagonists / adverse effects
  • Antithyroid Agents / administration & dosage
  • Dyspnea / chemically induced*
  • Fatal Outcome
  • Female
  • Heart Arrest / chemically induced*
  • Heart Arrest / physiopathology
  • Heart Arrest / therapy
  • Humans
  • Inhalation Exposure / adverse effects*
  • Methimazole / administration & dosage
  • Middle Aged
  • Multiple Organ Failure / chemically induced*
  • Multiple Organ Failure / physiopathology
  • Multiple Organ Failure / therapy
  • Polyurethanes / adverse effects*
  • Potassium Iodide / administration & dosage
  • Propranolol / administration & dosage
  • Propranolol / adverse effects
  • Resuscitation
  • Thyroid Crisis / chemically induced*
  • Thyroid Crisis / drug therapy
  • Thyroid Crisis / physiopathology

Substances

  • Adrenergic beta-Antagonists
  • Antithyroid Agents
  • Polyurethanes
  • Potassium Iodide
  • Methimazole
  • Propranolol