Thyroid Crisis

Definition:
Thyroid crisis is a medical emergency in which there is rapid deterioration of thyrotoxicosis.
Clinical Findings:
Hyperpyrexia.
Severe tachycardia.
Nausea.
Vomiting.
Diarrhea.
Dehydration.
Extreme restlessness.
Precipitating Factors:
Stress.
Infection.
Surgery in the unprepared patient.
Radioiodine therapy.

Management:
Propranolol - 0.5-2 mg IV 4 hourly.
or
20 - 120 mg orally 6 hourly.

Carbimazole - 25 mg 6 hourly.

Iodine - given 1 hour later as Lugol's solution/ sodium iodine.

Steroids - Hydrocortisone 50 mg 6 hourly.

* Aspirin should be avoided.

Types of Thyroid Crisis:

• Toxic Solitary Thyroid Nodules.
• Toxic Multinodular Goiter.
• Subacute Thyroiditis.
• Hashimoto's Thyroiditis.