A case of thyroid storm; a challenge to diagnose 

Abstract

Thyroid storm is a malignant presentation of hyperthyroidism which has a mortality rate of 10% to 30% around the world. Lack of direct laboratory test has made the diagnosis of thyroid storm a challenge in clinical practice. There is no consensus about the diagnosis of thyroid storm and the clinical view, which experience of the practitioner is vital for proper diagnosis of this situation. Early diagnosis may lead to fast initiation of aggressive treatment to prevent mortality. In this report, we present a case of thyroid storm which was first approached based on her gastrointestinal (GI) symptoms and re-visited in our center because of no improvement in her GI symptoms and also addition of CNS manifestations. 

Keywords: Thyroid storm, Hyperthyroidism, Thyrotoxicosis, Toxic multi nodular goiter