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December 1969

Thyroid Storm: A Review of 22 Episodes With Special Emphasis on the Use of Guanethidine

Author Affiliations

Columbus, Ohio

From the Division of Endocrinology and Metabolism, Department of Medicine, Ohio State University Hospitals, Columbus, Ohio.

Arch Intern Med. 1969;124(6):684-690. doi:10.1001/archinte.1969.00300220036006

Twenty patients with 22 episodes of thyroid storm were seen between 1949 and 1969. A precipitating event, most often underlying infection, could usually be identified. The protein-bound iodine level, not previously reported in a large series of patients with thyroid storm, was significantly higher (20.8ug/100 cc) than that seen in a group of patients with uncomplicated thyrotoxicosis. Hyperglycemia was observed frequently and returned to euglycemic levels with remission of thyroid storm, a fact not heretofore emphasized. The level of consciousness and degree of mentation were valuable prognostic signs with coma indicating a more serious outcome. Improving level of consciousness and mentation were seen with a favorable response to therapy. Survival improved to 93% during the last ten years. This improvement was attributed to early diagnosis and the addition of guanethidine sulfate to the existing regimen.