Coma and thyroid storm in apathetic thyrotoxicosis

• Published in: Southern medical journal (Birmingham, Ala.) Vol. 95; no. 5; pp. 552 - 554
• Main Authors: GHOBRIAL, Michel W, RUBY, Edward B
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 01-05-2002; Southern Medical Association
• Subjects: Affective Symptoms - etiology; Aged; Aged, 80 and over; Biological and medical sciences; Case studies; Coma; Coma - etiology; Diagnosis, Differential; Endocrinopathies; Female; Humans; Hyperthyroidism; Medical sciences; Non tumoral diseases. Target tissue resistance. Benign neoplasms; Physiological aspects; Thyroid Crisis - complications; Thyroid Crisis - diagnosis; Thyroid gland; Thyroid. Thyroid axis (diseases); Thyrotoxicosis - diagnosis; United States; Endocrinopathy; Coma; Steroid; Storm activity; Thyroid gland; Propylthiouracil; Thioureas; Complication; Female; Diagnosis; Neurological disorder; Thyrotoxic crisis; Iodine; Sonography; Human; Nervous system diseases; Antithyroid agent; Consciousness impairment; Thyroid diseases; Case study; Chemotherapy; Treatment; Echography; Rehydration; Elderly; Beta blocking agent
• ISSN: 0038-4348; 1541-8243
• DOI: 10.1097/00007611-200205000-00019

We report the case of an 87-year-old woman with coma who was found to be in thyrotoxic crisis. The patient had a recent history of decreased mentation and apathy, and laboratory findings were found to be consistent with hyperthyroidism. After a stormy course, the clinical condition recovered to baseline, with return of laboratory values to normal following antithyroid therapy. We provide the details of this rarely documented presentation of apathetic hyperthyroidism with thyroid storm and coma and review the characteristics of similar cases in the literature.