Key result
Thyroid storm can trigger extreme BNP elevation to ~9950 pg/mL without matching cardiac dysfunction.
Why the study?
Thyroid storm is a life-threatening endocrine emergency with rare reports of extraordinarily high BNP levels and unclear correlation between BNP and cardiac function in this context.
Case Report (n=1)
BNP levels can be extraordinarily elevated in cases of thyroid storm and take longer to normalize than actual cardiac function, emphasizing the need to rely on echocardiography rather than BNP alone for assessing hemodynamics.
Urges caution interpreting BNP in thyroid storm; leaves open its reliability as a cardiac function marker in thyrotoxicosis.
Thyroid storm is an extreme manifestation of thyrotoxicosis and represents a life-threatening endocrine emergency. Here, we report a 51-year-old woman with severe thyrotoxicosis and markedly elevated brain natriuretic peptide (BNP) level of 9950 pg/mL. Cardiac evaluation revealed poor left ventricular systolic performance. While thyroid function can affect BNP level, such extreme elevation is rare in cases of thyrotoxic crisis. This case highlighted the discrepancy between the clinical course and BNP level, emphasizing the need to recognize that BNP level may not always accurately reflect cardiac function in thyroid storm.
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Ishii et al. (2025) conducted a case report in Thyroid storm (n=1). Thyroid storm was evaluated on Brain natriuretic peptide (BNP) level. In a 51-year-old woman with thyroid storm, BNP levels reached an extraordinarily high 9950 pg/mL and took two months to normalize, indicating BNP may not accurately reflect actual cardiac function.
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