Thyroid storm is a rare but life-threatening endocrine emergency that can present with a wide range of clinical manifestations, which may delay diagnosis, particularly in atypical cases. We present a case series of three patients with thyroid storm to highlight its clinical variability and management challenges. We describe three patients with thyroid storm who presented with distinct clinical patterns, including neurological involvement with seizures, an obstetric trigger with severe systemic deterioration, and a case complicated by atrial fibrillation and ischemic stroke. In all cases, a precipitating factor was identified, and treatment was initiated with beta-blockers, corticosteroids, and methimazole. Although scoring systems such as the Burch-Wartofsky Point Scale were useful, they did not always fully reflect clinical severity, particularly in the presence of comorbid conditions. All patients showed clinical improvement with treatment. These cases illustrate the clinical variability of thyroid storm and the importance of clinical judgment in diagnosis. They also support the use of methimazole as a reasonable therapeutic option, within the limitations of this case series, in settings where propylthiouracil is not available.
Daniel Balderrama (Sat,) studied this question.