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Thyreotoxicosis

Clinical syndrome of thyrotoxicosis is the manifestation of tissue exposure to high levels of circulating thyroid hormones, which is accompanied by characteristic changes in their function. The most common form of thyrotoxicosis, which is caused by excessive thyroid gland, is hyperthyroidism. Shift from thyreotoxicosis of any type to a life-threatening state of a thyrotoxic crisis can caused by stress (emotional stress, intercurrent illness, surgery), destruction of functional tissue (radioiodine treatment), stable iodine (contrast medium administration) or abrupt withdrawal of thyrostatic agents. The failure of all compensatory mechanisms exacerbates the symptoms of toxicosis: agitation to delusional states, profuse sweating in hyperthermia, vomiting, diarrhea, hyperventilation, rhythm disorders and systolic dysfunction will accelerate the development of circulatory and metabolic failure. If treatment is not promptly initiated, mortality is high. This algorithm will guide you through the issue of thyreotoxicosis with a focus on its diagnosis and treatment.

Author: Hana Harazim, MD, Denisa Ölveczká, Tereza Tesaříková

Institution: Faculty of Medicine at Masaryk University in Brno

Medical discipline: Emergency Medicine

Keywords: thyrotoxicosis | thyroid gland | antithyroid drugs

Educational evel: Undergraduate level | Graduate

Clinical syndrome of thyrotoxicosis is the manifestation of tissue exposure to high levels of circulating thyroid hormones, which is accompanied by characteristic changes in their function. The most common form of thyrotoxicosis, which is caused by excessive thyroid gland, is hyperthyroidism. Shift from thyreotoxicosis of any type to a life-threatening state of a thyrotoxic crisis can caused by stress (emotional stress, intercurrent illness, surgery), destruction of functional tissue (radioiodine treatment), stable iodine (contrast medium administration) or abrupt withdrawal of thyrostatic agents. The failure of all compensatory mechanisms exacerbates the symptoms of toxicosis: agitation to delusional states, profuse sweating in hyperthermia, vomiting, diarrhea, hyperventilation, rhythm disorders and systolic dysfunction will accelerate the development of circulatory and metabolic failure. If treatment is not promptly initiated, mortality is high.
This algorithm will guide you through the issue of thyreotoxicosis with a focus on its diagnosis and treatment.


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Review

Reviewer:

Jitka Síkorová, MD, Senior Physician, 1st Department of Internal Medicine, University Hospital Pilsen, Pilsen, Czech Republic

Tyreotoxicosis is a clinical and biochemical condition caused by overproduction and the action of circulating thyroid hormones. This teaching material is not only about thyrotoxicosis in its own sense, but also points to the basic principles of treating a rare thyrotoxic crisis characterized by a severe or exacerbated clinical manifestation of hyperthyroidism. Gradually, a clinical picture is presented, with emphasis on dominant cardiac symptomatology, diagnosis, acute management of the patient, and, last but not least, definitive treatment of the disease. Consideration is given to availability in the treatment of recommended formulations in our conditions, and the pharmacological effects on the basis of which the particular drug is preferred. By studying the algorithm you can obtain the most important information about thyrotoxicosis and its most frequent cause.

publikováno: 25.5.2017 | last modified on: 16.5.2018