Thyroid : official journal of the American Thyroid Association
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Practice Guideline
Hyperthyroidism and other causes of thyrotoxicosis: management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists.
Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This article describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspeciality physicians and others providing care for patients with this condition. ⋯ One hundred evidence-based recommendations were developed to aid in the care of patients with thyrotoxicosis and to share what the task force believes is current, rational, and optimal medical practice.
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Thyroid storm and severe decompensated thyrotoxicosis are life-threatening diseases, requiring immediate treatment in an intensive care unit. Thyrotoxic heart disease is common in patients with hyperthyroidism; thyrotoxic cardiomyopathy with poor left ventricular systolic function is rare. Here, we report a patient who presented with severe decompensated thyrotoxicosis and reversible thyrotoxic cardiomyopathy after ingestion of a mixed seafood stew thought to contain tetrodotoxin or a related marine neurotoxin. ⋯ The patient reported here developed thyroid storm and cardiac decompensation shortly after a clinical event consistent with ingestion of marine neurotoxin. This adds to the list of stresses that have been associated with thyroid storm and emphasizes the need to fully evaluate patients who, on initial evaluation, appear to have only a single disorder.