{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:10:02Z","timestamp":1756311002832,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2018,11,1]],"date-time":"2018-11-01T00:00:00Z","timestamp":1541030400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,11,24]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:p>Hyperthyroidism is a common metabolic disorder, although its presentation as an endocrine emergency called thyroid storm is rare. Here we review a case of a thyroid storm as the initial presentation of thyrotoxicosis, with multiple organ failure and haemodynamic collapse due to low-output cardiac dysfunction. Quick intervention with aggressive antithyroid therapy, including steroid pulse, and supportive intensive care measures led to an outstanding improvement and full recovery. The present case clearly shows the beneficial impact of initial clinical suspicion resulting in an early diagnosis and intensive therapy. Moreover, it supports the additional role of steroids to aggressive antithyroid strategy in order to control associated deleterious systemic inflammatory reactions.<\/jats:p>","DOI":"10.1136\/bcr-2018-226669","type":"journal-article","created":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T17:19:47Z","timestamp":1545153587000},"page":"e226669","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Thyroid storm: a case of haemodynamic failure promptly reversed by aggressive medical therapy with antithyroid agents and steroid pulse"],"prefix":"10.1136","volume":"11","author":[{"given":"Ivan","family":"Andrade Luz","sequence":"first","affiliation":[{"name":"Nephrology, Centro Hospitalar do M\u00e9dio Tejo EPE, Unidade de Torres Novas, Torres Novas, Santar\u00e9m, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tiago","family":"Pereira","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Centro Hospitalar do M\u00e9dio Tejo EPE, Unidade de Abrantes, Abrantes, Santar\u00e9m, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuno","family":"Catorze","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Centro Hospitalar do M\u00e9dio Tejo EPE, Unidade de Abrantes, Abrantes, Santar\u00e9m, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,12,14]]},"reference":[{"key":"2025082708495023000_11.1.e226669.1","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2011.0334"},{"key":"2025082708495023000_11.1.e226669.2","doi-asserted-by":"publisher","DOI":"10.1177\/0885066613498053"},{"key":"2025082708495023000_11.1.e226669.3","doi-asserted-by":"crossref","first-page":"182","DOI":"10.4158\/EP14023.OR","article-title":"Clinical characteristics and outcome of thyroid storm: a case series and review of neuropsychiatric derangements in thyrotoxicosis","volume":"21","author":"Swee","year":"2015","journal-title":"Endocr Pract"},{"key":"2025082708495023000_11.1.e226669.4","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1111\/ped.13102","article-title":"Low cardiac output thyroid storm in a girl with Graves' disease","volume":"58","author":"Chantra","year":"2016","journal-title":"Pediatr Int"},{"key":"2025082708495023000_11.1.e226669.5","first-page":"337","article-title":"Tormenta tiroidea asociada a disfunci\u00f3n multiorg\u00e1nica caso cl\u00ednico discusi\u00f3n","volume":"77","author":"Baena","year":"2017","journal-title":"Med"},{"key":"2025082708495023000_11.1.e226669.6","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1002\/ams2.104","article-title":"Acute and emergency care for thyrotoxicosis and thyroid storm","volume":"2","author":"Idrose","year":"2015","journal-title":"Acute Med Surg"},{"key":"2025082708495023000_11.1.e226669.7","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1507\/endocrj.EJ16-0336","article-title":"2016 Guidelines for the management of thyroid storm from the japan thyroid association and japan endocrine society (First edition)","volume":"63","author":"Satoh","year":"2016","journal-title":"Endocr J"},{"key":"2025082708495023000_11.1.e226669.8","doi-asserted-by":"crossref","first-page":"e7053","DOI":"10.1097\/MD.0000000000007053","article-title":"Rapid improvement of thyroid storm-related hemodynamic collapse by aggressive anti-thyroid therapy including steroid pulse: a case report","volume":"96","author":"Kiriyama","year":"2017","journal-title":"Medicine"},{"key":"2025082708495023000_11.1.e226669.9","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq014"},{"key":"2025082708495023000_11.1.e226669.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-2828(08)80015-6"},{"key":"2025082708495023000_11.1.e226669.11","doi-asserted-by":"publisher","DOI":"10.1530\/eje.0.1420231"},{"key":"2025082708495023000_11.1.e226669.12","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2016.0229"},{"key":"2025082708495023000_11.1.e226669.13","unstructured":"Mulind J . Goiter: background, patophysiology, epidemiology, prognosis and patient education. 2018 https:\/\/emedicine.medscape.com\/article\/120034-overview (cited 2 Sep 2018)."},{"key":"2025082708495023000_11.1.e226669.14","doi-asserted-by":"crossref","first-page":"98","DOI":"10.4274\/jcrpe.1818","article-title":"Normative data of thyroid volume-ultrasonographic evaluation of 422 subjects aged 0-55 Years","volume":"7","author":"Ayd\u0131ner","year":"2015","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"2025082708495023000_11.1.e226669.15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1148\/rg.342135067","article-title":"The thyroid: review of imaging features and biopsy techniques with radiologic-pathologic correlation","volume":"34","author":"Nachiappan","year":"2014","journal-title":"Radiographics"},{"key":"2025082708495023000_11.1.e226669.16","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0889-8529(18)30165-8","article-title":"Life-threatening thyrotoxicosis. 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