Thyroid crisis is a complication of high levels of thyroid hormone in the blood (hyperthyroidism), which is not treated properly. This condition is classified as serious and fatal. The excessive release of thyroid hormone that occurs during a thyroid crisis can lead to the failure of a number of organs. Thyroid crisis is mostly experienced by women, especially during puberty.
Thyroid Crisis Symptoms
Thyroid crisis has the same symptoms as hyperthyroidism, but develops quickly over a few hours. The following are symptoms of a thyroid crisis:
- Fever over 38.5 degrees Celsius.
- Sweating constantly.
- Nervous, restless, and confused.
- Shaking (tremor).
- Muscles become weak, especially in the upper arms and thighs.
- Diarrhea.
- Hard to breathe.
- Stomach pain.
- Vomiting.
- Hard to breathe.
- Tachycardia or fast heartbeat.
- seizures.
- Loss of consciousness.
Causes of Thyroid Crisis
Thyroid crisis develops when hyperthyroidism is not treated properly. In this condition, there is excessive release of thyroid hormone by the thyroid gland.
Thyroid hormone functions to regulate the work of cells in the body, such as processing nutrients and converting them into energy. When the hormone is released in excess, the cells become overworked, and symptoms of a thyroid crisis arise.
The following are some of the factors that can increase the risk of a thyroid crisis:
- Post surgery.
- Thyroid gland damage.
- Do not take hyperthyroidism drugs as recommended by your doctor.
- Pregnancy.
- Stroke, heart failure, diabetic ketoacidosis and pulmonary embolism.
Thyroid Crisis Diagnosis
Thyroid crisis is an emergency, so diagnosis and treatment must be done as soon as possible to prevent multiple organ failure which can be fatal. In order to identify a thyroid crisis, the diagnosis is determined from the symptoms felt and will be confirmed by the doctor through a physical examination. If the patient's condition matches the signs of a thyroid crisis, the doctor will immediately initiate treatment without waiting for the results of laboratory tests.
Meanwhile, although the results of laboratory tests come out later, this examination is still necessary, especially for patients who previously did not know they had hyperthyroidism. The most important laboratory tests are blood tests, which include:
- Examination of thyroid hormone levels and hormones that stimulate the work of the thyroid gland (TSH). In people with thyroid crisis, thyroid hormone levels will be higher than normal, and TSH will be lower than normal.
- Complete blood count, to detect infection in the body.
- Measurement of gas and electrolyte levels in the blood.
- Measurement of calcium levels. Thyroid crisis is also characterized by calcium levels that are higher than normal.
In addition to blood tests, other investigations that may be suggested by the doctor are:
- Urine test (urinalysis).
- Chest X-ray, to see an enlarged heart and accumulation of fluid in the lungs due to heart failure.
- Electrocardiography, to detect heart rhythm disturbances.
- CT scan of the head, to see the condition of the nerves.
Thyroid Crisis Treatment
Treatment of thyroid crisis should be done as soon as possible through intensive care in the hospital, because the patient's condition must be continuously monitored. The goal of treatment is to overcome the production and release of excessive thyroid hormone and overcome the decline in organ function experienced by the patient.
Treatment efforts can be done by giving antithyroid drugs to control activities that increase thyroid hormone levels. The example is propylthiouracil (PTU) or methimazole. In addition to antithyroid, Lugol's fluid (potassium iodide), heart rhythm control drugs, and corticosteroids are also given. To relieve the symptoms of shortness of breath, the doctor will give additional oxygen. Meanwhile, to treat fever, doctors can give fever-reducing drugs, such as paracetamol.
The patient's condition usually begins to improve within 1-3 days after treatment. Once the thyroid crisis has passed, the patient's condition needs to be re-evaluated by an endocrinologist to determine the continuation of treatment. Regular medication and therapy can prevent a thyroid crisis from occurring.
If the above forms of treatment are not effective, then surgical removal of the thyroid gland can be an option to treat thyroid crisis.
