methimazole and Stroke

Thyroid storm is a rare disorder with a sudden onset, rapid progression and high mortality. We experienced a case of thyroid storm which had a devastating course, including multiple organ failure (MOF), severe hypoglycemia, disseminated intravascular coagulation (DIC), and stroke. It was difficult to make a diagnosis of thyroid storm in the present patient, because she did not have a history of thyroid disease and her serum FT3 level was normal. Clinicians should be aware that thyroid storm can occur even when there is an almost normal level of thyroid hormones, and that intensive anticoagulation is required for patients with atrial fibrillation to prevent stroke after thyroid storm.

Topics: Anti-Inflammatory Agents; Anticoagulants; Antithyroid Agents; Brain Edema; Decompression, Surgical; Disseminated Intravascular Coagulation; Female; Gabexate; Humans; Hydrocortisone; Methimazole; Middle Aged; Multiple Organ Failure; Stroke; Thyroid Crisis; Treatment Outcome; Triiodothyronine; Warfarin