Cargando…

Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm

Thyroid storm (TS) is a relatively rare but life-threatening complication of an overactive thyroid that can manifest in a myriad of ways due to its multisystem involvement. Due to its relatively high mortality rate, it is essential that TS is recognized and treated promptly. TS can occur due to trau...

Descripción completa

Detalles Bibliográficos
Autores principales: Joseph, Andrew M, Karas, Monica, Camba, Victor H, Martin, Brian M, Preece, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612572/
https://www.ncbi.nlm.nih.gov/pubmed/37900434
http://dx.doi.org/10.7759/cureus.46138
_version_ 1785128730944864256
author Joseph, Andrew M
Karas, Monica
Camba, Victor H
Martin, Brian M
Preece, John
author_facet Joseph, Andrew M
Karas, Monica
Camba, Victor H
Martin, Brian M
Preece, John
author_sort Joseph, Andrew M
collection PubMed
description Thyroid storm (TS) is a relatively rare but life-threatening complication of an overactive thyroid that can manifest in a myriad of ways due to its multisystem involvement. Due to its relatively high mortality rate, it is essential that TS is recognized and treated promptly. TS can occur due to trauma, drugs, and sepsis. Identifying TS as a diagnosis is challenging to pinpoint due to its similar presentation to more common pathologies like sepsis and diabetic ketoacidosis (DKA). Here, we present a case of a 31-year-old African-American woman with type 2 diabetes mellitus following sepsis secondary to Escherichia coli pyelonephritis and DKA. Despite standard sepsis treatment, which included appropriate intravenous fluids and antibiotics, the patient did not improve. Further workup, utilizing the Burch-Wartofsky score, helped identify TS as the underlying cause of the patient’s hospitalization, despite no history of underlying thyroid disease. The inclusion of thyroid pathology as part of the differential diagnosis and workup of a patient with a sepsis-like presentation to avoid anchoring bias warrants further investigation.
format Online
Article
Text
id pubmed-10612572
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-106125722023-10-29 Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm Joseph, Andrew M Karas, Monica Camba, Victor H Martin, Brian M Preece, John Cureus Endocrinology/Diabetes/Metabolism Thyroid storm (TS) is a relatively rare but life-threatening complication of an overactive thyroid that can manifest in a myriad of ways due to its multisystem involvement. Due to its relatively high mortality rate, it is essential that TS is recognized and treated promptly. TS can occur due to trauma, drugs, and sepsis. Identifying TS as a diagnosis is challenging to pinpoint due to its similar presentation to more common pathologies like sepsis and diabetic ketoacidosis (DKA). Here, we present a case of a 31-year-old African-American woman with type 2 diabetes mellitus following sepsis secondary to Escherichia coli pyelonephritis and DKA. Despite standard sepsis treatment, which included appropriate intravenous fluids and antibiotics, the patient did not improve. Further workup, utilizing the Burch-Wartofsky score, helped identify TS as the underlying cause of the patient’s hospitalization, despite no history of underlying thyroid disease. The inclusion of thyroid pathology as part of the differential diagnosis and workup of a patient with a sepsis-like presentation to avoid anchoring bias warrants further investigation. Cureus 2023-09-28 /pmc/articles/PMC10612572/ /pubmed/37900434 http://dx.doi.org/10.7759/cureus.46138 Text en Copyright © 2023, Joseph et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Endocrinology/Diabetes/Metabolism
Joseph, Andrew M
Karas, Monica
Camba, Victor H
Martin, Brian M
Preece, John
Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm
title Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm
title_full Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm
title_fullStr Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm
title_full_unstemmed Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm
title_short Anchoring on Hyperglycemia and Sepsis in the Presence of an Unforeseen Thyroid Storm
title_sort anchoring on hyperglycemia and sepsis in the presence of an unforeseen thyroid storm
topic Endocrinology/Diabetes/Metabolism
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10612572/
https://www.ncbi.nlm.nih.gov/pubmed/37900434
http://dx.doi.org/10.7759/cureus.46138
work_keys_str_mv AT josephandrewm anchoringonhyperglycemiaandsepsisinthepresenceofanunforeseenthyroidstorm
AT karasmonica anchoringonhyperglycemiaandsepsisinthepresenceofanunforeseenthyroidstorm
AT cambavictorh anchoringonhyperglycemiaandsepsisinthepresenceofanunforeseenthyroidstorm
AT martinbrianm anchoringonhyperglycemiaandsepsisinthepresenceofanunforeseenthyroidstorm
AT preecejohn anchoringonhyperglycemiaandsepsisinthepresenceofanunforeseenthyroidstorm