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Definition
Distinction between thyroid storm and thyrotoxicosis.

Thyroid storm = thyrotoxic crises, decompensated thyrotoxicosis, and accelerated thyrotoxicosis, is a life-threatening form of severe hyperthyroidism.

Causes

 * Graves disease (most common)


 * Toxic adenoma (hot nodule)

Other rare causes: TSH-producing pituitary adenomas, trophoblastic tumors producing hCG, struma ovarii
 * Toxic multi-nodular goiter

Signs and Symptoms
In addition to typical features of hyperthyroidism (tachycardia, tremulousness), thyroid storm is also accompanied by other features (fever, mental status changes, diarrhea, vomiting, hepatitis, arrhythmia, myocardial ischemia, and congestive heart failure). Mortality can be as high as 20-30%.

Physiology
The causes of thyroid storm are multifactorial. Elevated iodothyronine concentrations are only one of many components. Rather, the transition from thyrotoxicosis to thyroid storm is ignited by non-thyroidal triggers including, but not limited to fever, sepsis, dehydration, myocardial infarction and psychiatric diseases.

According to newer theories thyroid storm results from allostatic failure in a situation were thyrotoxicosis hampers the development of non-thyroidal illness syndrome, which would help to save energy in situations of high metabolic demand