Abstract
IntroductionThyroid storm is a medical emergency associated with significant mortality. Hyperthyroid states have been associated with hypercoagulability as well as rhabdomyolysis. However, the pathophysiology of this association remains under investigation.Case ReportA 62-year-old male patient presented to the emergency department with weakness and was found to have thyroid storm with concurrent submassive pulmonary embolisms and rhabdomyolysis. To our knowledge, this is the first reported presentation of this triad.ConclusionThis case highlights the potentially difficult diagnosis and management of thyroid storm, as well as associated life-threatening complications, including venous thromboemboli and rhabdomyolysis.
Highlights
Thyroid storm is a medical emergency associated with significant mortality
Hyperthyroid states exist on a spectrum of disease severity; this spectrum ranges from subclinical hyperthyroidism to clinical manifestations of this hormone derangement, or thyrotoxicosis, to the most severe form with multisystem involvement and evidence of systemic decompensation – thyroid storm.[1]
A clear dose response of free T4 (FT4) in both pulmonary embolism (PE) and deep vein thrombosis (DVT) has been established.[7]. While this association could be attributed to a non-thyroidal illness syndrome, in which a decrease in peripheral conversion of T4 to T3 is seen, this has been generally dismissed in the literature based on increased levels of T3 in cases of venous thromboembolic (VTE) associated with hyperthyroid disease.[7]
Summary
Thyroid storm is a medical emergency associated with significant mortality. Hyperthyroid states have been associated with hypercoagulability as well as rhabdomyolysis. The pathophysiology of this association remains under investigation. Case Report: A 62-year-old male patient presented to the emergency department with weakness and was found to have thyroid storm with concurrent submassive pulmonary embolisms and rhabdomyolysis. To our knowledge, this is the first reported presentation of this triad
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