What is the treatment for a thyroid storm?

What is the treatment for a thyroid storm?

• A. Start levothyroxine
• B. Maintain airway, provide ventilation, administer glucocorticoids and antithyroid drugs
• C. Increase iodine intake
• D. Do nothing

Answer: (B)

Thyroid storm is a life-threatening surge of thyroid hormone that requires immediate stabilization and rapid suppression of hormone production and release. The most important steps are to secure the airway and ensure adequate ventilation and circulation, because respiratory failure or shock can occur quickly in this crisis. At the same time, you need to pharmacologically blunt the excess thyroid effect: give an antithyroid drug to stop new hormone synthesis, and administer glucocorticoids to reduce peripheral conversion of T4 to the more active T3 and to treat potential adrenal insufficiency. Iodine therapy can be added after the antithyroid drug to block release of stored thyroid hormone. Starting levothyroxine would worsen the crisis, and doing nothing is inappropriate in a life-threatening situation.

Thyroid storm is a life-threatening surge of thyroid hormone that requires immediate stabilization and rapid suppression of hormone production and release. The most important steps are to secure the airway and ensure adequate ventilation and circulation, because respiratory failure or shock can occur quickly in this crisis. At the same time, you need to pharmacologically blunt the excess thyroid effect: give an antithyroid drug to stop new hormone synthesis, and administer glucocorticoids to reduce peripheral conversion of T4 to the more active T3 and to treat potential adrenal insufficiency. Iodine therapy can be added after the antithyroid drug to block release of stored thyroid hormone. Starting levothyroxine would worsen the crisis, and doing nothing is inappropriate in a life-threatening situation.