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Hyperthyroid crisis, in other words, is an exacerbation of hyperthyroidism. Belongs to an extremely rare but very dangerous for life and health complications that can develop in patients with hyperthyroidism.
Hyperthyroid crisis also known as a thyrotoxic storm is an extreme sign of hyperthyroidism, due to the overproduction of thyroid hormones. The rapid rising of their levels results in hypercatabolic, or uncontrolled cell disintegration, which may, in turn, lead to large quantities of metabolic products of protein, which can poison the body. Despite the fact that it occurs mostly in patients diagnosed with hyperthyroidism, it may also be the first symptom of hyperthyroidism. Most often, however, it concerns people who have stopped taking drugs that inhibit the production of thyroid hormones or have been subjected to improper treatment.
Early diagnosis and aggressive treatment are necessary because hyperthyroid crisis occurs frequently in patients with nodular goiter overactive or toxic goiter of the thyroid, as well as in patients with Graves’ disease.
Factors that increase the risk of thyrotoxic storm in patients diagnosed with hyperthyroidism are:
- severe burns;
- an overdose of thyroid hormones;
- pulmonary embolism;
- diabetic ketoacidosis;
- surgery (eg. the operation of the thyroid);
- The preparations of drugs or contrast media containing iodine;
The symptoms of hyperthyroid crisis
Thyroid crisis is a very rare complication, touches in fact, an average of 1-2% of people with hyperthyroidism. Diagnosis and treatment, therefore, requires different methods, since they may be accompanied by the tachycardia and change the mental state of the patient. Among the most common symptoms can be found:
- fever, even above 41 ° C, excessive sweating, and dehydration;
- increased heart rate, higher than 140 beats per minute (with or without atrial fibrillation or other cardiac arrhythmias), hypertension, cardiac arrhythmias, congestive heart failure;
- nausea, jaundice, vomiting, diarrhea, abdominal pain, weight loss;
- confusion, agitation, delirium, psychosis, insomnia, seizures.
Hyperthyroid crisis is a directly life-threatening condition because it can lead to circulatory collapse. In addition, it can result in multiple organ failure or coma. After the emergence of the symptoms of the thyrotoxic storm, it is necessary to immediately call the ambulance.
Treatment and first aid at hyperthyroid crisis
A person who has the first alarming symptoms must immediately get to the hospital, in here the time and speed are very important, by a reason of the high risk of complications and even death. The patient before the arrival of emergency requires some cold compresses and reduction of the body temperature.
Being under the care of doctors, the patient should receive the medicaments inhibiting the synthesis of thyroid hormones and oxygen. In the hospital, it is necessary to make transfusion of plasma and blood, the alignment of electrolyte disturbances and reduction of the body temperature. In some cases, it is important also to use beta-blockers, which would protect the heart against the influx of thyroid hormones. In the next step, the patient receives drugs which inhibit the secretion of thyroid hormones. There are also situations in which the patient need an additional blood cleansing by dialysis. Recovery is slow, patients are usually very weak, have symptoms of muscle damage and require a longer rest in bed.
Hyperthyroid crisis, can often be confused with pheochromocytoma adrenal medulla, drug intoxication or vegetative crisis. Similar symptoms occur also after ingestion of psychotropic drugs, in individuals exposed to excessive stress, by staying at high temperatures (eg. in a tropical climate) or being at risk of overexposure to the sun.
Hyperthyroid crisis could only be countered by appropriate treatment of hyperthyroidism and early diagnosis of symptoms.