{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T16:32:06Z","timestamp":1787589126992,"version":"build-2736575974"},"reference-count":88,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T00:00:00Z","timestamp":1773360000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Hyperthyroidism is a prevalent endocrine disorder that can lead to severe multisystem complications, including atrial fibrillation (AF), thyrotoxic periodic paralysis (TPP), and thyroid storm (TS). This review discusses the pathophysiology, clinical presentation, and management challenges of these complications through illustrative clinical cases. AF is the most common cardiovascular manifestation, with restoration of euthyroidism and rate control being central to treatment. TPP presents with transient muscle weakness due to hypokalemia from intracellular potassium shift, requiring cautious potassium supplementation and hyperthyroidism control. TS is a life-threatening endocrine emergency characterized by multisystem decompensation, necessitating prompt multimodal therapy including antithyroid drugs, beta-blockers, corticosteroids, and supportive care. Thus, early recognition and tailored management remain the cornerstones of successful treatment for these severe complications of hyperthyroidism.<\/jats:p>","DOI":"10.1210\/clinem\/dgag112","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T15:47:10Z","timestamp":1773330430000},"page":"1751-1764","source":"Crossref","is-referenced-by-count":1,"title":["Approach to the patient with severe hyperthyroidism-related complications"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1081-334X","authenticated-orcid":false,"given":"Georgios","family":"Kostopoulos","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Metabolism, Hippokration General Hospital , 54642 Thessaloniki ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7313-8391","authenticated-orcid":false,"given":"Grigoris","family":"Effraimidis","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Health Sciences, University of Thessaly , 41110 Larissa ,","place":["Greece"]},{"name":"Department of Endocrinology and Metabolic Diseases, Larissa University Hospital , 41110 Larissa ,","place":["Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2026,3,13]]},"reference":[{"issue":"5","key":"2026082411571233900_dgag112-B1","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1038\/nrendo.2018.18","article-title":"Global epidemiology of hyperthyroidism and hypothyroidism","volume":"14","author":"Taylor","year":"2018","journal-title":"Nat Rev Endocrinol"},{"issue":"15","key":"2026082411571233900_dgag112-B2","doi-asserted-by":"crossref","first-page":"1472","DOI":"10.1001\/jama.2023.19052","article-title":"Hyperthyroidism: a review","volume":"330","author":"Lee","year":"2023","journal-title":"JAMA"},{"issue":"4","key":"2026082411571233900_dgag112-B3","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1016\/S2213-8587(23)00005-0","article-title":"Hyperthyroidism: aetiology, pathogenesis, diagnosis, management, complications, and prognosis","volume":"11","author":"Wiersinga","year":"2023","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"2","key":"2026082411571233900_dgag112-B4","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1210\/clinem\/dgac635","article-title":"Approach to the patient with a suppressed TSH","volume":"108","author":"Praw","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"2026082411571233900_dgag112-B5","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1159\/000438750","article-title":"The 2015 European Thyroid Association guidelines on diagnosis and treatment of endogenous subclinical hyperthyroidism","volume":"4","author":"Biondi","year":"2015","journal-title":"Eur Thyroid J"},{"issue":"10","key":"2026082411571233900_dgag112-B6","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis","volume":"26","author":"Ross","year":"2016","journal-title":"Thyroid"},{"issue":"2","key":"2026082411571233900_dgag112-B7","doi-asserted-by":"crossref","first-page":"e230254","DOI":"10.1530\/ETJ-23-0254","article-title":"Epidemiology, prognosis, and challenges in the management of hyperthyroidism-related atrial fibrillation","volume":"13","author":"Kostopoulos","year":"2024","journal-title":"Eur Thyroid J"},{"key":"2026082411571233900_dgag112-B8","doi-asserted-by":"crossref","first-page":"213","DOI":"10.2147\/CLEP.S47385","article-title":"Epidemiology of atrial fibrillation: European perspective","volume":"6","author":"Zoni-Berisso","year":"2014","journal-title":"Clin Epidemiol"},{"issue":"1","key":"2026082411571233900_dgag112-B9","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1161\/CIRCRESAHA.120.316340","article-title":"Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights","volume":"127","author":"Kornej","year":"2020","journal-title":"Circ Res"},{"key":"2026082411571233900_dgag112-B10","doi-asserted-by":"crossref","first-page":"e7895","DOI":"10.1136\/bmj.e7895","article-title":"The spectrum of thyroid disease and risk of new onset atrial fibrillation: a large population cohort study","volume":"345","author":"Selmer","year":"2012","journal-title":"BMJ"},{"issue":"8","key":"2026082411571233900_dgag112-B11","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.eprac.2022.05.008","article-title":"Effects of thyroid dysfunction and the thyroid-stimulating hormone levels on the risk of atrial fibrillation: a systematic review and dose-response meta-analysis from cohort studies","volume":"28","author":"Huang","year":"2022","journal-title":"Endocr Pract"},{"issue":"3","key":"2026082411571233900_dgag112-B12","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.1210\/jc.2014-3586","article-title":"Thyroid function in the euthyroid range and adverse outcomes in older adults","volume":"100","author":"Cappola","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026082411571233900_dgag112-B13","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1001\/jamacardio.2018.4635","article-title":"Assessment of the relationship between genetic determinants of thyroid function and atrial fibrillation: a Mendelian randomization study","volume":"4","author":"Ellervik","year":"2019","journal-title":"JAMA Cardiol"},{"issue":"2","key":"2026082411571233900_dgag112-B14","doi-asserted-by":"crossref","first-page":"e57893","DOI":"10.1371\/journal.pone.0057893","article-title":"New-onset atrial fibrillation is a predictor of subsequent hyperthyroidism: a nationwide cohort study","volume":"8","author":"Selmer","year":"2013","journal-title":"PLoS One"},{"issue":"6","key":"2026082411571233900_dgag112-B15","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1016\/j.mayocp.2022.12.013","article-title":"Incidence, risk factors, and outcomes of incident atrial fibrillation in patients with Graves disease","volume":"98","author":"Naser","year":"2023","journal-title":"Mayo Clin Proc"},{"issue":"15","key":"2026082411571233900_dgag112-B16","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1001\/archinte.164.15.1675","article-title":"Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study","volume":"164","author":"Frost","year":"2004","journal-title":"Arch Intern Med"},{"issue":"3","key":"2026082411571233900_dgag112-B17","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/j.chest.2018.09.011","article-title":"A simple clinical risk score (C(2)HEST) for predicting incident atrial fibrillation in Asian subjects: derivation in 471,446 Chinese subjects, with internal validation and external application in 451,199 Korean subjects","volume":"155","author":"Li","year":"2019","journal-title":"Chest"},{"issue":"1","key":"2026082411571233900_dgag112-B18","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1161\/CIR.0000000000001193","article-title":"2023 ACC\/AHA\/ACCP\/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology\/American Heart Association Joint Committee on clinical practice guidelines","volume":"149","author":"Joglar","year":"2024","journal-title":"Circulation"},{"issue":"36","key":"2026082411571233900_dgag112-B19","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"issue":"4","key":"2026082411571233900_dgag112-B20","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1159\/000490384","article-title":"2018 European Thyroid Association guideline for the management of Graves' hyperthyroidism","volume":"7","author":"Kahaly","year":"2018","journal-title":"Eur Thyroid J"},{"issue":"6","key":"2026082411571233900_dgag112-B21","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1093\/europace\/euy051","article-title":"European Heart Rhythm Association (EHRA) position paper on arrhythmia management and device therapies in endocrine disorders, endorsed by Asia Pacific Heart Rhythm Society (APHRS) and Latin American Heart Rhythm Society (LAHRS)","volume":"20","author":"Gorenek","year":"2018","journal-title":"Europace"},{"issue":"11","key":"2026082411571233900_dgag112-B22","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1038\/nrcardio.2017.153","article-title":"The ABC pathway: an integrated approach to improve AF management","volume":"14","author":"Lip","year":"2017","journal-title":"Nat Rev Cardiol"},{"key":"2026082411571233900_dgag112-B23","doi-asserted-by":"crossref","first-page":"101757","DOI":"10.1016\/j.eclinm.2022.101757","article-title":"Adherence to the atrial fibrillation better care (ABC) pathway and the risk of major outcomes in patients with atrial fibrillation: a post-hoc analysis from the prospective GLORIA-AF registry","volume":"55","author":"Romiti","year":"2023","journal-title":"EClinicalMedicine"},{"issue":"6","key":"2026082411571233900_dgag112-B24","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1016\/0002-9343(82)90850-6","article-title":"Management of atrial fibrillation in the post-thyrotoxic state","volume":"72","author":"Nakazawa","year":"1982","journal-title":"Am J Med"},{"issue":"9","key":"2026082411571233900_dgag112-B25","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.1002\/ccr3.1700","article-title":"Alternating hyperthyroidism and hypothyroidism in Graves' disease","volume":"6","author":"Wong","year":"2018","journal-title":"Clin Case Rep"},{"key":"2026082411571233900_dgag112-B26","doi-asserted-by":"crossref","first-page":"4281","DOI":"10.2147\/IJGM.S484910","article-title":"Radioactive iodine-131 therapy reduced the risk of MACEs and all-cause mortality in elderly with hyperthyroidism combined with type 2 diabetes","volume":"17","author":"Guo","year":"2024","journal-title":"Int J Gen Med"},{"key":"2026082411571233900_dgag112-B27","doi-asserted-by":"crossref","first-page":"1032764","DOI":"10.3389\/fendo.2022.1032764","article-title":"Graves' disease, its treatments, and the risk of atrial fibrillation: a Korean population-based study","volume":"13","author":"Cho","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"2","key":"2026082411571233900_dgag112-B28","doi-asserted-by":"crossref","first-page":"e240393","DOI":"10.1530\/ETJ-24-0393","article-title":"Variable hyperthyroidism outcomes related to different treatment regimens: an analysis of UK Biobank data","volume":"14","author":"Elomaa","year":"2025","journal-title":"Eur Thyroid J"},{"issue":"7","key":"2026082411571233900_dgag112-B29","doi-asserted-by":"crossref","first-page":"2415","DOI":"10.1210\/jc.2007-0199","article-title":"Clinical review: thyroid dysfunction and effects on coagulation and fibrinolysis: a systematic review","volume":"92","author":"Squizzato","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"5","key":"2026082411571233900_dgag112-B30","doi-asserted-by":"crossref","first-page":"1352","DOI":"10.3390\/jcm11051342","article-title":"Yearly incidence of stroke and bleeding in atrial fibrillation with concomitant hyperthyroidism: a national discharge database study","volume":"11","author":"Zhang","year":"2022","journal-title":"J Clin Med"},{"key":"2026082411571233900_dgag112-B31","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.ahj.2021.08.018","article-title":"Increased risk of ischemic stroke and systemic embolism in hyperthyroidism-related atrial fibrillation: a nationwide cohort study","volume":"242","author":"Kim","year":"2021","journal-title":"Am Heart J"},{"issue":"12","key":"2026082411571233900_dgag112-B32","doi-asserted-by":"crossref","first-page":"1500","DOI":"10.1093\/eurheartj\/ehr488","article-title":"Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients with atrial fibrillation: the Swedish atrial fibrillation cohort study","volume":"33","author":"Friberg","year":"2012","journal-title":"Eur Heart J"},{"issue":"1","key":"2026082411571233900_dgag112-B33","doi-asserted-by":"crossref","first-page":"45","DOI":"10.5334\/gh.871","article-title":"Risk of thromboembolism in non-valvular atrial fibrillation with or without clinical hyperthyroidism","volume":"16","author":"Lin","year":"2021","journal-title":"Glob Heart"},{"issue":"5","key":"2026082411571233900_dgag112-B34","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): the task force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur Heart J"},{"issue":"5","key":"2026082411571233900_dgag112-B35","doi-asserted-by":"crossref","first-page":"e220166","DOI":"10.1530\/EC-22-0166","article-title":"Efficacy and safety of anticoagulation in thyrotoxic atrial fibrillation: a systematic review and meta-analysis","volume":"11","author":"Tng","year":"2022","journal-title":"Endocr Connect"},{"issue":"9","key":"2026082411571233900_dgag112-B36","doi-asserted-by":"crossref","first-page":"1406","DOI":"10.1016\/j.amjcard.2019.07.046","article-title":"Characteristics and outcomes of atrial fibrillation in patients with thyroid disease (from the ARISTOTLE trial)","volume":"124","author":"Goldstein","year":"2019","journal-title":"Am J Cardiol"},{"issue":"8","key":"2026082411571233900_dgag112-B37","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1002\/clc.22427","article-title":"Benefit of anticoagulation therapy in hyperthyroidism-related atrial fibrillation","volume":"38","author":"Chan","year":"2015","journal-title":"Clin Cardiol"},{"issue":"9","key":"2026082411571233900_dgag112-B38","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1210\/clinem\/dgaa050","article-title":"Direct oral anticoagulants in atrial fibrillation patients with concomitant hyperthyroidism","volume":"105","author":"Chan","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"issue":"24","key":"2026082411571233900_dgag112-B39","doi-asserted-by":"crossref","first-page":"2947","DOI":"10.2169\/internalmedicine.50.6135","article-title":"Risk factors for persistent atrial fibrillation following successful hyperthyroidism treatment with radioiodine therapy","volume":"50","author":"Zhou","year":"2011","journal-title":"Intern Med"},{"issue":"6","key":"2026082411571233900_dgag112-B40","doi-asserted-by":"crossref","first-page":"e240164","DOI":"10.1530\/ETJ-24-0164","article-title":"Thyrotoxic periodic paralysis\u2014a retrospective study from Southern India","volume":"13","author":"Paul","year":"2024","journal-title":"Eur Thyroid J"},{"issue":"11","key":"2026082411571233900_dgag112-B41","doi-asserted-by":"crossref","first-page":"2597","DOI":"10.1001\/archinte.1989.00390110139031","article-title":"Thyrotoxic periodic paralysis. Report of 10 cases and review of electromyographic findings","volume":"149","author":"Kelley","year":"1989","journal-title":"Arch Intern Med"},{"issue":"5","key":"2026082411571233900_dgag112-B42","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1111\/j.1445-5994.2007.01313.x","article-title":"Thyrotoxic, hypokalaemic periodic paralysis: Polynesians, an ethnic group at risk","volume":"37","author":"Elston","year":"2007","journal-title":"Intern Med J"},{"issue":"7","key":"2026082411571233900_dgag112-B43","doi-asserted-by":"crossref","first-page":"2490","DOI":"10.1210\/jc.2006-0356","article-title":"Clinical review: thyrotoxic periodic paralysis: a diagnostic challenge","volume":"91","author":"Kung","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026082411571233900_dgag112-B44","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.jemermed.2022.10.023","article-title":"Thyrotoxic periodic paralysis: an under-recognized cause of paralysis in young hispanic men","volume":"64","author":"Gulde","year":"2023","journal-title":"J Emerg Med"},{"key":"2026082411571233900_dgag112-B45","first-page":"e58","article-title":"Thyrotoxic periodic paralysis: eight cases in males of Hispanic origin from a single hospital","volume":"2","author":"Amblee","year":"2015","journal-title":"AACE Clin Case Rep"},{"issue":"16","key":"2026082411571233900_dgag112-B46","doi-asserted-by":"crossref","first-page":"1514","DOI":"10.1056\/NEJMcpc2312728","article-title":"Case 13-2024: a 27-year-old man with leg weakness","volume":"390","author":"Allegretti","year":"2024","journal-title":"N Engl J Med"},{"key":"2026082411571233900_dgag112-B47","first-page":"22-0236","article-title":"Subacute thyroiditis associated with thyrotoxic periodic paralysis after COVID-19 vaccination: a case report","volume":"2022","author":"Murashita","year":"2022","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"issue":"6810","key":"2026082411571233900_dgag112-B48","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1136\/bmj.303.6810.1096","article-title":"In vivo and in vitro sodium pump activity in subjects with thyrotoxic periodic paralysis","volume":"303","author":"Chan","year":"1991","journal-title":"BMJ"},{"issue":"1","key":"2026082411571233900_dgag112-B49","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1210\/jc.2006-0552","article-title":"Thyroid hormone increases mRNA and protein expression of Na+-K+-ATPase alpha2 and beta1 subunits in human skeletal muscles","volume":"92","author":"Phakdeekitcharoen","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"2026082411571233900_dgag112-B50","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/0026-0495(72)90071-6","article-title":"Elevated immunoreactive insulin concentration during spontaneous attacks in thyrotoxic periodic paralysis","volume":"21","author":"Shishiba","year":"1972","journal-title":"Metabolism"},{"issue":"5","key":"2026082411571233900_dgag112-B51","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1111\/j.1365-2265.2008.03395.x","article-title":"Insulin resistance in subjects with a history of thyrotoxic periodic paralysis (TPP)","volume":"70","author":"Soonthornpun","year":"2009","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"2","key":"2026082411571233900_dgag112-B52","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1111\/j.1365-2265.1994.tb02532.x","article-title":"Hyperinsulinaemia and Na+, K(+)-ATPase activity in thyrotoxic periodic paralysis","volume":"41","author":"Chan","year":"1994","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"6","key":"2026082411571233900_dgag112-B53","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1681\/ASN.2012010046","article-title":"Mechanism of thyrotoxic periodic paralysis","volume":"23","author":"Lin","year":"2012","journal-title":"J Am Soc Nephrol"},{"issue":"5","key":"2026082411571233900_dgag112-B54","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1530\/EJE-13-0381","article-title":"A 10-year analysis of thyrotoxic periodic paralysis in 135 patients: focus on symptomatology and precipitants","volume":"169","author":"Chang","year":"2013","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"2026082411571233900_dgag112-B55","first-page":"301","article-title":"Manifestation of thyrotoxic periodic paralysis in two patients with adrenal adenomas and hyperandrogenaemia","volume":"59","author":"Biering","year":"2003","journal-title":"Horm Res"},{"issue":"1","key":"2026082411571233900_dgag112-B56","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.cell.2009.12.024","article-title":"Mutations in potassium channel Kir2.6 cause susceptibility to thyrotoxic hypokalemic periodic paralysis","volume":"140","author":"Ryan","year":"2010","journal-title":"Cell"},{"issue":"5","key":"2026082411571233900_dgag112-B57","doi-asserted-by":"crossref","first-page":"e274","DOI":"10.1212\/NXG.0000000000000274","article-title":"Increased KCNJ18 promoter activity as a mechanism in atypical normokalemic periodic paralysis","volume":"4","author":"Soufi","year":"2018","journal-title":"Neurol Genet"},{"issue":"5","key":"2026082411571233900_dgag112-B58","doi-asserted-by":"crossref","first-page":"e193348","DOI":"10.1001\/jamanetworkopen.2019.3348","article-title":"Assessment of molecular subtypes in thyrotoxic periodic paralysis and Graves disease among Chinese Han adults: a population-based genome-wide association study","volume":"2","author":"Zhao","year":"2019","journal-title":"JAMA Netw Open"},{"issue":"2","key":"2026082411571233900_dgag112-B59","first-page":"274","article-title":"Thyrotoxic periodic paralysis: clinical and molecular aspects","volume":"43","author":"Falhammar","year":"2013","journal-title":"Endocrine"},{"key":"2026082411571233900_dgag112-B60","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/9781119374800.ch18","volume-title":"Endocrine and Metabolic Medical Emergencies","author":"Vanderpump","year":"2018"},{"issue":"3","key":"2026082411571233900_dgag112-B61","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1053\/ajkd.2001.22090","article-title":"Propranolol rapidly reverses paralysis, hypokalemia, and hypophosphatemia in thyrotoxic periodic paralysis","volume":"37","author":"Lin","year":"2001","journal-title":"Am J Kidney Dis"},{"issue":"1","key":"2026082411571233900_dgag112-B62","first-page":"66","article-title":"A rare case of thyrotoxic periodic paralysis in a patient with concomitant methimazole-induced agranulocytosis","volume":"11","author":"Wei","year":"2024","journal-title":"AACE Clin Case Rep"},{"key":"2026082411571233900_dgag112-B63","first-page":"100235","article-title":"Impact of first-line treatment choice on long-term outcomes of hyperthyroid Graves' disease patients with thyrotoxic periodic paralysis","volume":"21","author":"Karndumri","year":"2020","journal-title":"J Clin Transl Endocrinol"},{"issue":"1","key":"2026082411571233900_dgag112-B64","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1080\/01676830.2023.2296553","article-title":"Intravenous methylprednisolone-induced hypokalaemic periodic paralysis in a thyrotoxic patient: a case report and literature review","volume":"44","author":"Wanas","year":"2025","journal-title":"Orbit"},{"issue":"4","key":"2026082411571233900_dgag112-B65","doi-asserted-by":"crossref","first-page":"313","DOI":"10.14310\/horm.2002.1323","article-title":"Hypokalemic paralysis following administration of intravenous methylprednisolone in a patient with Graves' thyrotoxicosis and ophthalmopathy","volume":"10","author":"Tigas","year":"2011","journal-title":"Hormones (Athens)"},{"issue":"1","key":"2026082411571233900_dgag112-B66","first-page":"22-0358","article-title":"High-dose intravenous hydrocortisone for the treatment of hyperthyroidism: a rare precipitant of thyrotoxicosis periodic paralysis","volume":"2023","author":"Scheive","year":"2023","journal-title":"Endocrinol Diabetes Metab Case Rep"},{"issue":"10","key":"2026082411571233900_dgag112-B67","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1016\/j.eprac.2025.06.010","article-title":"Thyroid emergencies: a narrative review","volume":"31","author":"Kruithoff","year":"2025","journal-title":"Endocr Pract"},{"issue":"1","key":"2026082411571233900_dgag112-B68","doi-asserted-by":"crossref","first-page":"e87","DOI":"10.1210\/clinem\/dgae124","article-title":"Prospective multicenter registry-based study on thyroid storm: the guidelines for management from Japan are useful","volume":"110","author":"Furukawa","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026082411571233900_dgag112-B69","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1089\/thy.2018.0275","article-title":"National trends in incidence, mortality, and clinical outcomes of patients hospitalized for thyrotoxicosis with and without thyroid storm in the United States, 2004-2013","volume":"29","author":"Galindo","year":"2019","journal-title":"Thyroid"},{"issue":"11","key":"2026082411571233900_dgag112-B70","doi-asserted-by":"crossref","first-page":"3084","DOI":"10.1210\/clinem\/dgaf150","article-title":"National trends in US hospitalizations and outcomes of thyrotoxicosis with and without thyrotoxic storm, 2016 to 2020","volume":"110","author":"Uwumiro","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026082411571233900_dgag112-B71","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1089\/thy.2018.0353","article-title":"Unfavorable socioeconomic factors underlie high rates of hospitalization for complicated thyrotoxicosis in some regions of the United States","volume":"29","author":"Rivas","year":"2019","journal-title":"Thyroid"},{"issue":"7","key":"2026082411571233900_dgag112-B72","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1089\/thy.2011.0334","article-title":"Diagnostic criteria, clinical features, and incidence of thyroid storm based on nationwide surveys","volume":"22","author":"Akamizu","year":"2012","journal-title":"Thyroid"},{"issue":"10","key":"2026082411571233900_dgag112-B73","doi-asserted-by":"crossref","first-page":"e250696","DOI":"10.1136\/bcr-2022-250696","article-title":"Thyroid storm induced by combined nivolumab and ipilimumab immunotherapy in advanced non-small cell lung cancer","volume":"15","author":"Kataoka","year":"2022","journal-title":"BMJ Case Rep"},{"issue":"5","key":"2026082411571233900_dgag112-B74","doi-asserted-by":"crossref","first-page":"679","DOI":"10.7326\/0003-4819-72-5-679","article-title":"Apathetic thyrotoxicosis: a distinctive clinical and laboratory entity","volume":"72","author":"Thomas","year":"1970","journal-title":"Ann Intern Med"},{"issue":"6","key":"2026082411571233900_dgag112-B75","doi-asserted-by":"crossref","first-page":"2715","DOI":"10.1210\/jc.2009-2495","article-title":"Older subjects with hyperthyroidism present with a paucity of symptoms and signs: a large cross-sectional study","volume":"95","author":"Boelaert","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2026082411571233900_dgag112-B76","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1210\/jc.2014-2850","article-title":"Clinical features and hospital outcomes in thyroid storm: a retrospective cohort study","volume":"100","author":"Angell","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"issue":"9","key":"2026082411571233900_dgag112-B77","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1177\/10507256251367267","article-title":"The point scale for thyroid storm-32 years and (still) counting","volume":"35","author":"Burch","year":"2025","journal-title":"Thyroid"},{"issue":"2","key":"2026082411571233900_dgag112-B78","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0889-8529(18)30165-8","article-title":"Life-threatening thyrotoxicosis. Thyroid storm","volume":"22","author":"Burch","year":"1993","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"12","key":"2026082411571233900_dgag112-B79","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"},{"issue":"25","key":"2026082411571233900_dgag112-B80","doi-asserted-by":"crossref","first-page":"1688","DOI":"10.1056\/NEJM199512213332507","article-title":"Drugs and thyroid function","volume":"333","author":"Surks","year":"1995","journal-title":"N Engl J Med"},{"issue":"3","key":"2026082411571233900_dgag112-B81","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/0735-6757(91)90083-V","article-title":"Emergency department management of thyrotoxic crisis with esmolol","volume":"9","author":"Brunette","year":"1991","journal-title":"Am J Emerg Med"},{"issue":"1","key":"2026082411571233900_dgag112-B82","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1186\/s13054-020-03188-8","article-title":"Early administration of glucocorticoid for thyroid storm: analysis of a national administrative database","volume":"24","author":"Senda","year":"2020","journal-title":"Crit Care"},{"issue":"4","key":"2026082411571233900_dgag112-B83","doi-asserted-by":"crossref","first-page":"e238655","DOI":"10.1001\/jamanetworkopen.2023.8655","article-title":"Comparison of propylthiouracil vs methimazole for thyroid storm in critically ill patients","volume":"6","author":"Lee","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"3","key":"2026082411571233900_dgag112-B84","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1089\/thy.2023.0068","article-title":"Iodine in the therapy of Graves' disease: a century after Henry S. Plummer","volume":"33","author":"Kopp","year":"2023","journal-title":"Thyroid"},{"issue":"4","key":"2026082411571233900_dgag112-B85","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1586\/eem.10.40","article-title":"Role of iodine in thyroid physiology","volume":"5","author":"Leung","year":"2010","journal-title":"Expert Rev Endocrinol Metab"},{"issue":"2","key":"2026082411571233900_dgag112-B86","doi-asserted-by":"crossref","first-page":"e310","DOI":"10.1210\/clinem\/dgae187","article-title":"Potassium iodide use and patient outcomes for thyroid storm: an observational study","volume":"110","author":"Matsuo","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2026082411571233900_dgag112-B87","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/j.1365-2265.1993.tb00970.x","article-title":"Adjunctive cholestyramine therapy for thyrotoxicosis","volume":"38","author":"Solomon","year":"1993","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"4","key":"2026082411571233900_dgag112-B88","doi-asserted-by":"crossref","first-page":"e250010","DOI":"10.1530\/EDM-25-0010","article-title":"Plasmapheresis for the treatment of thyroid storm","volume":"2025","author":"Osorio-Toro","year":"2025","journal-title":"Endocrinol Diabetes Metab Case Rep"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgag112\/67338903\/dgag112.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/6\/1751\/67338903\/dgag112.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/111\/6\/1751\/67338903\/dgag112.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T15:57:27Z","timestamp":1787587047000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/111\/6\/1751\/8519180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,13]]},"references-count":88,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,3,13]]},"published-print":{"date-parts":[[2026,5,19]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgag112","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,3,13]]}}}