[Iodine-induced hyperthyroidism in metastatic thyroid carcinoma]

Recurrent thyroid storm induced by heretofore unrecognised causes in a patient with thyroid cancer

An unusual encounter of a thyroid storm, on two separate occasions, is reported in a patient with metastatic differentiated thyroid cancer following initially direct trauma to, and later tumour embolisation of, a metastatic skeletal lesion. Shortly after a fall, our patient presented with pain and swelling in the right shoulder, high fever, change in mental status, anorexia, nausea and vomiting, tachycardia and dehydration. The laboratory tests were consistent with hyperthyroidism. As the patient improved, arterial embolisation of the large right humerus metastasis was performed to decrease the tumour burden. The patient, however, developed a similar clinical and biochemical picture to that at her presentation, with a very high free thyroxine (T(4)) level, a few days after successful embolisation. Treatment of the thyroid storm was initiated and the patient eventually improved. Awareness of such occurrences is helpful in early diagnosis and effective management of this potentially fatal complication.

Thyrotoxic crisis induced by cytotoxic chemotherapy

Thyroid storm is a rare and life-threatening medical emergency. We report a young lady with Graves' disease and acute myeloid leukaemia who developed thyrotoxic crisis following an induction course of chemotherapy given for the treatment of acute leukaemia. After successful management of her leukaemia and thyroid disease, she received an autologous bone marrow transplantation.