Key result
Emergent total thyroidectomy achieves rapid stabilization in refractory amiodarone-induced thyroid storm.
Why the study?
Thyroid storm secondary to amiodarone is a challenging clinical emergency with high mortality risk and complex management strategies.
Case Report (n=1)
Emergent total thyroidectomy is an effective definitive treatment for severe amiodarone-induced thyroid storm refractory to medical therapy.
May support thyroidectomy in refractory amiodarone storm with shock; leaves open confirmation in prospective studies.
Thyroid storm is a thyroid emergency with increased risk for mortality due to elevated levels of circulating thyroid hormone. While it can be caused by a variety of etiologies, thyroid storm secondary to amiodarone can be particularly challenging to manage. This paper describes a case of a 65-year-old man who presented from out-of-hospital with persistent ventricular tachycardia and multiple implantable defibrillator firings from thyroid storm following amiodarone infusion. Despite conventional first-line pharmacotherapy, he developed cardiogenic shock and multi-organ failure requiring therapeutic plasma exchange. Due to continued deterioration, he underwent emergent total thyroidectomy. Following surgery, the patient experienced clinical stabilization and has now made a complete recovery. In this paper, we highlight the complexities in the management of amiodarone induced thyrotoxicosis and offer a treatment algorithm and indications for early, definitive management with thyroidectomy.
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Freeman et al. (2023) conducted a case report in Amiodarone-induced thyroid storm (n=1). Emergent total thyroidectomy was evaluated on Clinical stabilization and recovery. Emergent total thyroidectomy resulted in clinical stabilization and complete recovery in a patient with refractory amiodarone-induced thyroid storm.
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