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American Journal of Medical Case Reports. 2021, 9(8), 436-437
DOI: 10.12691/AJMCR-9-8-14
Case Report

Calm before the Storm: Contrast-induced Thyroid Storm

Sahra Ahmadi1, and Usha Anand1

1Department of Internal Medicine, WellStar Kennestone Medical Center, Marietta, GA, United States of America

Pub. Date: May 13, 2021
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Cite this paper

Sahra Ahmadi and Usha Anand. Calm before the Storm: Contrast-induced Thyroid Storm. American Journal of Medical Case Reports. 2021; 9(8):436-437. doi: 10.12691/AJMCR-9-8-14

Abstract

Hyperthyroidism is a state of excess circulating thyroid hormone. These hormones control many of the body’s most important functions such as breathing, heart rate, weight, digestion, and moods. The extreme manifestation of thyrotoxicosis is referred to as thyroid storm. Thyroid storm manifests as an acute, severe, life-threatening hypermetabolic state caused by either excess release of thyroid hormones or an altered peripheral response to thyroid hormone following the presence of one or more precipitants. Thyroid storm is an uncommon but potentially fatal endocrine emergency. Mortality reaching between 80 – 100% without treatment in thyroid storm with multiple organ failure as the most common cause of death. During thyroid storm, precipitants multiply the effect of thyroid hormones by freeing thyroid hormones from binding sites, increased sensitivity in tissue receptors, or post-receptor modifications in signaling pathways. The most common precipitating factor is infection along with a host of other causes. Of interest, iodinated contrast is an important precipitating factor to consider as it is commonly used in the hospital setting through imaging modalities. Elderly patients are at higher risk due to the increased prevalence of nodular thyroid disease. Care must be taken to quickly recognize and treat this potentially fatal illness.

Keywords

thyroid storm, contrast, thyrotoxicosis

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Dunne P, Kaimal N, MacDonald J, Syed AA. Iodinated contrast-induced thyrotoxicosis. CMAJ. 2013 Feb 5; 185(2): 144-7.
 
[2]  Lee SY, Rhee CM, Leung AM, Braverman LE, Brent GA, Pearce EN. A review: Radiographic iodinated contrast media-induced thyroid dysfunction. J Clin Endocrinol Metab. 2015 Feb; 100(2): 376-83.
 
[3]  Thumma, Soumya MD; Manchala, Venkata MD; Mattana, Joseph MD. Radiocontrast-Induced Thyroid Storm, American Journal of Therapeutics: September/October 2019 - Volume 26 - Issue 5 - p e644-e645.