CLINICAL CHARACTERISTICS AND DEFINITIVE TREATMENT FOLLOWING THYROID STORM

10-YEAR EXPERIENCE

Abstract

INTRODUCTION
The prevalence of thyroid storm is 0.2 per 100,000 people per year with mortality rates varying from 11% to 25%. Given the rarity of occurrence and the high mortality rates associated with thyroid storm, it is imperative to understand the definitive therapy pattern following such an event.

METHODOLOGY
We conducted a retrospective review of the medical records of patients diagnosed with thyroid storm at Hospital Putrajaya between September 2013 and December 2023. Demographic data, comorbidities, definitive treatments, and patient outcomes were collected and analysed.

RESULT
We included 30 patients with thyroid storm. Most of the subjects were Malay and female. Mean age at diagnosis of thyroid storm was 42 years. Thyroid storm occurred after a mean duration of 57 months following diagnosis of thyrotoxicosis. Seven patients (23.3%) presented with thyroid storm as the initial clinical manifestation of thyrotoxicosis. Most were triggered by respiratory tract infections, followed by gastrointestinal and urinary tract infections. Three patients (10%) died due to multiorgan failure. Thirteen subjects (43.3%) received definitive treatment: twelve (40%) received radioactive iodine and one underwent thyroidectomy. Eight (26.7%) defaulted on follow-up. Three patients (10%) were on medical therapy and undecided on definitive treatment. The mean duration between thyroid storm and definitive treatment was about 5 months.

CONCLUSION
In our cohort, majority of patients with thyroid storm had similar clinical characteristics to those in previous studies. The mortality rate was slightly lower than in previous studies. Less than half of the patients received definitive treatment. Therefore, measures should be taken to improve our post-thyroid storm management.