关键词: emergency physician hyperthyroidism risk factors thyroid storm trauma

Mesh : Adult Diaphragm / abnormalities Emergency Service, Hospital / organization & administration Humans Hyperthyroidism / complications therapy Male Risk Factors Tachycardia / etiology Tachypnea / etiology Thyroid Crisis / diagnosis etiology Thyroid Function Tests Wounds and Injuries / complications

来  源:   DOI:10.1016/j.jemermed.2016.09.003   PDF(Sci-hub)

Abstract:
BACKGROUND: Thyroid storm, an endocrine emergency, remains a diagnostic and therapeutic challenge. It is recognized to develop as a result of several factors, including infection, surgery, acute illness, and rarely, trauma. Recognition of thyroid storm in a trauma patient is difficult because the emergency physician usually focuses on managing more obvious injuries.
OBJECTIVE: We present a case of trauma-related thyroid storm and review the previous literature on posttraumatic thyroid storm to delineate risk factors of the disease. The case occurred in a 32-year-old man after a motorcycle accident.
CONCLUSIONS: Careful investigation of patient history and risk factors of trauma-related thyroid storms and utilization of the scoring system may facilitate early diagnosis. Traumatically induced thyroid storm usually responds to medical treatment developed for hyperthyroidism. Surgical intervention may be needed for patients who failed medical treatment or those with direct thyroid gland injuries. The outcome is usually fair under appropriate management.
CONCLUSIONS: We present a case of trauma-related thyroid storm to illustrate the diagnostic and therapeutic approach with a summary of the previous literature. Emergency physicians should be aware of the clinical presentation and risk factors of patients with trauma-related thyroid storm to reduce the rate of misdiagnosis and prevent catastrophic outcomes.
摘要:
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