{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:28Z","timestamp":1784557048066,"version":"3.55.0"},"reference-count":16,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"Summary<\/jats:title>\n Thyroid storm is a rare but potentially life-threatening complication of hyperthyroidism. Early recognition and prompt treatment are essential. Atrial fibrillation can occur in up to 40% of patients with thyroid storm. Studies have shown that hyperthyroidism increases the risk of thromboembolic events. There is no consensus with regard to the initiation of anticoagulation for atrial fibrillation in severe thyrotoxicosis. Anticoagulation is not routinely initiated if the risk is low on a CHADS2 score; however, this should be considered in patients with thyroid storm or severe thyrotoxicosis with impending storm irrespective of the CHADS2 risk, as it appears to increase the risk of thromboembolic episodes. Herein, we describe a case of thyroid storm complicated by massive pulmonary embolism.<\/jats:p>\n \n Learning points<\/jats:title>\n \n \n \n Diagnosis of thyroid storm is based on clinical findings. Early recognition and prompt treatment could lead to a favourable outcome.<\/jats:p>\n <\/jats:list-item>\n \n Hypercoagulable state is a recognised complication of thyrotoxicosis.<\/jats:p>\n <\/jats:list-item>\n \n Atrial fibrillation is strongly associated with hyperthyroidism and thyroid storm.<\/jats:p>\n <\/jats:list-item>\n \n Anticoagulation should be considered for patients with severe thyrotoxicosis and atrial fibrillation irrespective of the CHADS2 score.<\/jats:p>\n <\/jats:list-item>\n \n Patients with severe thyrotoxicosis and clinical evidence of thrombosis should be immediately anticoagulated until hyperthyroidism is under control.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1530\/edm-13-0060","type":"journal-article","created":{"date-parts":[[2014,1,16]],"date-time":"2014-01-16T03:22:21Z","timestamp":1389842541000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":4,"title":["Thromboembolic complications of thyroid storm"],"prefix":"10.1530","volume":"2014","author":[{"given":"T","family":"Min","sequence":"first","affiliation":[{"name":"1ST4 Diabetes and Endocrinology, Princess of Wales Hospital, Bridgend CF31 1RQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Benjamin","sequence":"additional","affiliation":[{"name":"2Consultant Diabetes and Endocrinology, Princess of Wales Hospital, Bridgend CF31 1RQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L","family":"Cozma","sequence":"additional","affiliation":[{"name":"2Consultant Diabetes and Endocrinology, Princess of Wales Hospital, Bridgend CF31 1RQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"ref11","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","year":"2012","journal-title":"Thyroid"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1001\/archinte.1981.00340090087019","article-title":"Arterial embolism in thyrotoxicosis with atrial fibrillation","volume":"141","year":"1981","journal-title":"Archives of Internal Medicine"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1160\/TH12-07-0496","article-title":"The effect of hyperthyroidism on procoagulant, anticoagulant and fibrinolytic factors: a systematic review and meta-analysis","volume":"108","year":"2012","journal-title":"Thrombosis and Haemostasis"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1111\/j.1538-7836.2010.03993.x","article-title":"Increased risk of pulmonary embolism among patients with hyperthyroidism: a 5-year follow-up study","volume":"8","year":"2010","journal-title":"Journal of Thrombosis and Haemostasis"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1056\/NEJM199411103311901","article-title":"Low serum thyrotropin concentrations as a risk factor for atrial fibrillation in older persons","volume":"331","year":"1994","journal-title":"New England Journal of Medicine"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.1160\/TH12-07-0496","article-title":"The effect of hyperthyroidism on procoagulant, anticoagulant and fibrinolytic factors: a systematic review and meta-analysis","volume":"108","year":"2012","journal-title":"Thrombosis and Haemostasis"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1111\/j.1538-7836.2010.03993.x","article-title":"Increased risk of pulmonary embolism among patients with hyperthyroidism: a 5-year follow-up study","volume":"8","year":"2010","journal-title":"Journal of Thrombosis and Haemostasis"},{"key":"ref91","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","year":"2012","journal-title":"Thyroid"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/S0889-8529(18)30165-8","article-title":"Life-threatening thyrotoxicosis. 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