How is hyperthyroid crisis treated? What is an hyperthyroid crisis?

Hyperthyroid crisis refers to a condition in which the symptoms of hyperthyroidism suddenly worsen to a life-threatening degree due to certain triggers. The main manifestations are high fever, profuse sweating, extreme tachycardia, vomiting, diarrhea, irritability, and coma in severe cases, which can lead to death if not rescued in time. At present, with the development of diagnostic technology and the improvement of advanced methods; The incidence of hyperthyroid crises is much less than before.

However, because of this critical illness, if it is detected late and not treated properly, it can be life-threatening. Therefore, it is of great significance to prevent the occurrence of hyperthyroid crisis, early diagnosis and early diagnosis.

With regard to hyperthyroid crisis, a multifaceted and comprehensive approach should be taken:

1) Reduce the concentration of thyroid hormone in the blood circulation: 200-300 mg with propylthiouracil, once every 6 hours; If this drug is not available, 20-30 mg of methimazole can be used every 6 hours to block the synthesis of thyroid hormones. oral compound iodine solution, 30-50 drops every 6 hours; or intravenous infusion with sodium iodide** to suppress the release of thyroid hormones.

Methods such as partial plasma exchange or peritoneal dialysis may also be used to remove excess thyroid hormone from the circulation.

2) Reduce the response of surrounding tissues to the thyroid hormone catecholamines: some drugs such as reserpine, guanethidine and other catecholamines that deplete tissue storage; Propranolol and other drugs can block the action of adrenergic receptors, thereby reducing the response of surrounding tissues to the thyroid hormone catecholamine and play a leading role.

3) Others**: including the use of drugs or physical methods to reduce body temperature, strengthen support**, and give supplementary water, electrolytes, glucose, vitamins, etc., to meet the needs of the body's metabolism. Adrenocorticosteroids are relatively insufficient in hyperthyroidism, and appropriate application of adrenocorticosteroids can play a non-specific antipyretic and anti-shock effect.

In addition, the cause of hyperthyroid crisis should be actively sought out and removed, and effective antibiotics can be used if infected**.

Hyperthyroid crisis, a severe and life-threatening complication of thyrotoxicosis, is an uncommon but high mortality rate.

Hyperthyroidism crisis in the elderly, referred to as hyperthyroid crisis, is a serious complication of thyrotoxicosis that is extremely weight-increasing and life-threatening, and the disease is uncommon but has a high case fatality rate. High iodine and hyperthyroidism and hyperthyroid crisis: Since iodine supplementation for the prevention of endemic goiter, iodine-induced hyperthyroidism has been continuously reported.

Diagnosis of typical hyperthyroid crisis is not difficult, with a history of uncontrolled hyperthyroidism, symptoms and signs of hyperthyroidism, especially goiter with vascular bruits and exophthalmos, it is easy to make a clinical diagnosis. There are few people with typical manifestations in the elderly, and the symptoms of a certain system are often prominent, and the elderly over 70 years old should be more vigilant against apathetic hyperthyroid crisis. Serum TT4TT3, FT4, FT3, and TSH (IRMA method) levels are key to diagnosis.

At present, these test methods are relatively popular, and there is no need for special preparations such as iodine ban, and the test methods are becoming more and more simple, so that early diagnosis can be made in emergency conditions.

Thyroid storm is the most serious complication of hyperthyroidism (hyperthyroidism). It generally occurs when the condition is not ** or although the condition is not controlled, the condition is aggravated by some kind of stress and reaches a life-threatening state. Most crisis patients have certain triggers, and the most common causes in the past are insufficient preoperative preparation for hyperthyroidism, surgical stress and intraoperative operation to squeeze the thyroid gland, so that a large amount of thyroid hormone is released into the blood circulation, and the condition deteriorates rapidly, and hyperthyroid crisis can occur.

Actively and reasonably control hyperthyroidism, take traditional Chinese medicine (hyperthyroidism Pingfu decoction) internally, and prevent the occurrence of crises, which can prevent or reduce the occurrence of crises. When there is a pre-hyperthyroid crisis, it must be closely observed, even if there is no laboratory basis for the diagnosis of hyperthyroidism, if the patient's clinical manifestations are consistent with the hyperthyroid crisis, it should be performed immediately**, and the results of laboratory tests should not be waited, and the following emergency measures can be taken.

Cooling and symptomatic**: Physical cooling (ice packs, ice blankets) or acetaminophen can be used, and aspirin should be avoided. Other measures such as anti-infection, correction of water and electrolyte imbalances; Oxygen inhalation, anti-heart failure and anti-shock**, etc.

Hyperthyroid crisis is a rapid deterioration of the condition of hyperthyroidism, resulting in serious metabolic disorders throughout the body, and serious dysfunction of the cardiovascular system, digestive system, nervous system, etc., often life-threatening.

1: For triggers**2: Inhibition of thyroid hormone synthesis:

PTU 600 mg orally or via gastric tube is preferred, followed by 250 mg orally every 6 hours and reduced to the usual ** dose when symptoms resolve. 3: Inhibition of thyroid hormone release:

After taking PTU for 1 hour, add 5 drops of compound iodine oral solution, once every 8 hours, or add sodium iodide to 10% glucose saline solution intravenously for 24 hours, and then gradually reduce the dose according to the condition, generally used for 3-7 days. If you are allergic to iodine, you can switch to lithium carbonate orally in 3 divided doses for several days4: propranolol 20 40 mg orally every 6 to 8 hours, or 1 mg diluted intravenously.

5: Hydrocortisone 50 100mg added to 5% 10% glucose solution intravenously, once every 6 8 hours. 6：

When the above routine** results are not satisfactory, peritoneal dialysis, hemodialysis, or plasma exchange can be used to rapidly reduce plasma thyroid hormone concentrations. 7: Cooling:

Patients with high fever should be physically cooled and acetylsalicylic acid drugs should be avoided. 8: Other support**.

—Excerpted from Internal Medicine, People's Medical Publishing House, 7th Edition.

Hello, the clinical manifestations of hyperthyroid crisis: 1 tachycardia, rapid heart rate, more than 140 beats, may be accompanied by premature beats, atrial fibrillation, and even heart failure, pulmonary edema. 2 Nausea, vomiting, diarrhea, and even jaundice.

A small number of apathetic hyperthyroidism or elderly patients lack typical hyperthyroid crisis manifestations, which are manifested by low-grade fever, apathy, lethargy, systemic failure, shock, and coma and death. 3. Body temperature: often sudden onset of high fever, body temperature above 39, accompanied by profuse sweating and facial flushing.

4 Irritability, delirium, lethargy, coma.

Hyperthyroidism crisis is severe and life-threatening!

Diagnosis of aura crisis Diagnosis of aura crisis is defined as: body temperature between 38 and 39; heart rate is 120 159 min, arrhythmia may also be present; loss of appetite, nausea, increased frequency of stools, sweating; Anxiety, irritability, premonition of crisis.

Patients with hyperthyroid crisis may have: temperature between 38 and 39; heart rate is 120 159 min, arrhythmia may also be present; loss of appetite, nausea, increased frequency of stools, sweating; Anxiety, irritability, premonition of crisis.

The clinical symptoms of hyperthyroid crisis mainly include high fever, excessive sweating, tachycardia, increased blood pressure, arrhythmia, heart failure, irritability, anxiety, nausea, vomiting, etc.

Abbreviated as hyperthyroid crisis. It refers to a life-threatening state in which the condition of a patient with hyperthyroidism deteriorates rapidly under the action of certain triggers.

Hyperthyroid crisis type.

The incidence accounts for 1% and 2% of hyperthyroidism, and it is more common in the elderly, and is often related to infection, mental trauma, surgery, childbirth, overwork, sudden discontinuation, drug reactions and other complications, resulting in aggravation of hyperthyroidism and enhanced sympathetic nerve activity and crisis. In the early stage of crisis, fever can reach more than 39, pulse rate can reach 120 160 minutes, restlessness, loss of appetite, nausea, vomiting, diarrhea, trance, sweating, drowsiness, and develop to semi-coma and coma. A comatose patient is indicative of a pre-existing crisis and is very dangerous.

Elevated white blood cells, abnormal liver function, GPT, GOT, bilirubin, etc., dehydration, hypotension, electrolyte disorders, acidosis, heart failure, pulmonary edema, etc. Serum T3, T4, FT3, and FT4 can all be elevated, and the case fatality rate is high, so it must be rescued locally in time.

Symptoms of hyperthyroid crisis.

1.Velocity: rate increased up to 140 with premature contractions, atrial fibrillation to failure pulmonary edema.

2.Signs of malaise, vomiting, diarrhea, and even jaundice, a small number of apathetic hyperthyroidism, or patients lacking typical hyperthyroid crisis manifestations, manifest themselves as low-grade fever, apathy, drowsiness, systemic failure, shock, coma, and death.

3.Body temperature: sudden onset of high fever body temperature 39 with sweating and facial flushing.

4.Irritability, delirium, drowsiness, coma.

The pathogenesis of hyperthyroid crisis is currently clear, often hyperthyroidism is not ** or has not been controlled, and in the event of hyperthyroid crisis caused by certain hormones, if you want to prevent hyperthyroid crisis, you must actively ** hyperthyroidism.