A case of apathetic thyroid storm with resultant hyperthyroidism-induced hypercalcemia. 2013

Kristine I Parker, and Aundrea Loftley, and Carmina Charles, and Kathie Hermayer
Department of Endocrinology, Metabolism & Medical Genetics, The Medical University of South Carolina, Charleston, North Carolina.

Thyroid storm is a complication of thyrotoxicosis with a 20% to 30% mortality rate characterized by hyperthermia, tachycardia and altered mental status. Rarely, thyroid storm may have an apathetic presentation. The authors present a 63-year-old woman with apathetic thyrotoxicosis and hypercalcemia. The action of thyroid hormones stimulating bone resorption more than bone formation is thought to cause increased bone demineralization and, occasionally, hypercalcemia. This occurs in the absence of malignancy, prolonged immobility, hypervitaminosis D and primary hyperparathyroidism. Her thyroid storm was medically managed and her hypercalcemia was treated with intravenous fluids, calcitonin and a bisphosphonate. This case describes the presence of hypercalcemia in a patient with apathetic thyroid storm with no other factors contributing to the hypercalcemia. In addition, this patient had significant elevation in serum calcium, which possibly contributed to her symptomatology. The calcium remained normal after the thyrotoxicosis resolved, which is typical of the hypercalcemia of thyrotoxicosis.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011014 Pneumonia Infection of the lung often accompanied by inflammation. Experimental Lung Inflammation,Lobar Pneumonia,Lung Inflammation,Pneumonia, Lobar,Pneumonitis,Pulmonary Inflammation,Experimental Lung Inflammations,Inflammation, Experimental Lung,Inflammation, Lung,Inflammation, Pulmonary,Inflammations, Lung,Inflammations, Pulmonary,Lobar Pneumonias,Lung Inflammation, Experimental,Lung Inflammations,Lung Inflammations, Experimental,Pneumonias,Pneumonias, Lobar,Pneumonitides,Pulmonary Inflammations
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006934 Hypercalcemia Abnormally high level of calcium in the blood. Milk-Alkali Syndrome,Hypercalcemias,Milk Alkali Syndrome,Syndrome, Milk-Alkali
D013958 Thyroid Crisis A dangerous life-threatening hypermetabolic condition characterized by high FEVER and dysfunction of the cardiovascular, the nervous, and the gastrointestinal systems. Thyroid Storm,Thyrotoxic Crisis,Thyrotoxic Storm,Crisis, Thyrotoxic,Crisis, Thyroid,Storm, Thyroid,Storm, Thyrotoxic
D016896 Treatment Outcome Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series. Rehabilitation Outcome,Treatment Effectiveness,Clinical Effectiveness,Clinical Efficacy,Patient-Relevant Outcome,Treatment Efficacy,Effectiveness, Clinical,Effectiveness, Treatment,Efficacy, Clinical,Efficacy, Treatment,Outcome, Patient-Relevant,Outcome, Rehabilitation,Outcome, Treatment,Outcomes, Patient-Relevant,Patient Relevant Outcome,Patient-Relevant Outcomes

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