case of iatrogenic thyroid storm

Thyroid storm is a rare entity and can be fatal if not properly managed on time. A 75 year old lady reported to the emergency room with agitation, restlessness, breathlessness. On further evaluation she was found to have atrial fibrillation with a heart rate of 180 beats per minute. She was carrying a blood report indicative of thyrotoxicosis, which was confirmed subsequently. The patient was diagnosed as a case of thyroid storm and managed accordingly. On taking the detail history it was found that the patient had palpitation since last 2 years and had been taking levothyoxine 75 microgram/day after consulting a paramedical health worker in a hospital. The dose had been escalated to one and half tablet of 75mcg strength, in July 2021 as per the advice of the same health care worker after seeing the report. But the lab report of July 2021, the patient had, indicated thyrotoxicosis. Ideally the dose of levothyroxine should have been reduced or discontinued.