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2015 ; 8
(4
): 232-4
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Trauma triggering thyrotoxic crisis with lactic acidosis
#MMPMID26604530
Prosser JS
; Quan DK
J Emerg Trauma Shock
2015[Oct]; 8
(4
): 232-4
PMID26604530
show ga
Thyrotoxic crisis (TC) is defined as a life-threatening exacerbation of the
hyperthyroid state that causes multiple autonomic and metabolic disturbances. It
is considered to be an endocrine emergency that must be urgently diagnosed and
treated. We describe a case of TC precipitated by trauma with a resultant lactic
acidosis. The patient is a 24-year-old male with a history of hyperthyroidism who
presented to the emergency department following a motor vehicle accident. The
patient was initially tachycardic and hypertensive, however, was afebrile.
Initial laboratory analysis showed an anion gap of 26, lactic acid 7.6, free T4
5.61 and thyroid stimulating hormone < 0.015. A diagnosis of TC was made, and he
was treated with intravenous fluids, propranolol, and methimazole with
improvement of tachycardia and lactic acidosis. We discuss the features of this
case, which reviews the presentations of TC as well as its metabolic sequelae.