• Xinyao Li, Jun Chen, and Zhuo Li.
• Department of Emergency/Critical Medicine, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
• Medicine (Baltimore). 2023 Apr 7; 102 (14): e33447e33447.

RationaleThyroid storm (TS), also known as thyroid crisis, is a life-threatening condition that involves multiple organ dysfunction and high mortality due to uncontrolled hyperthyroidism. TS in children is extremely rare, early diagnosis and treatment can significantly improve the prognosis of the children.Patient ConcernsThree female children who diagnosed as "thyroid storm" were admitted to Pediatric Intensive Care Unit (PICU). One of them had a family history of hyperthyroidism and others had infection factors induced TS. They presented with characteristic manifestations of TS and were evaluated with Burch-Wartofsky Point Scale (BWPS) hyperthyroidism score.DiagnosesThree cases showed that free triiodothyronine 3 (FT3) and free triiodothyronine 4 (FT4) were increased and Thyroid-Stimulating-Hormone was significantly decreased, which were characteristic in hyperthyroidism. They presented with characteristic manifestations of TS and were evaluated with BWPS hyperthyroidism score.InterventionsAll the cases were given antithyroid drugs (ATDs) for treatment. In addition, 1 of them underwent therapeutic plasma exchange (TPE) after transferring to PICU.OutcomesOne of the cases was declared dead and others were survived.LessonsTS should be identified timely and treated early. Further studies are needed to determine the diagnostic criteria and scoring system for TS in pediatric.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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