Thyroid Storm Presenting as Psychosis

J Investig Med High Impact Case Rep. 2018 May 18;6:2324709618777014. doi: 10.1177/2324709618777014. eCollection Jan-Dec 2018.

Abstract

Thyroid storm is a life-threatening endocrine emergency with an incidence rate of 1% to 2%. It is a systemic condition of excessive thyroid hormone production and release leading to thermoregulatory, adrenergic, neuropsychiatric, cardiovascular, and abdominal manifestations. Although it is a rare condition, it carries a significant mortality rate. Hence, knowing the common and uncommon presentations of thyroid storm is important for its prompt diagnosis and treatment. In this article, we present an unusual case of a young woman who presented with psychosis as the manifesting symptom of thyroid storm. She did not respond adequately to conventional medical treatment, requiring plasmapheresis and a definitive thyroidectomy, which ultimately led to the return of patient's baseline mental status and a dramatic recovery.

Keywords: hyperthyroidism; plasmapheresis; psychosis; thyroid storm; thyrotoxicosis.