Kilpnäärmekriis

Kilpnäärmekriis is a severe and life-threatening complication that can arise from untreated or poorly managed thyroid disorders. It refers to a sudden and dramatic worsening of hyperthyroid symptoms, leading to a state of extreme metabolic imbalance. This condition is also known as thyroid storm or thyrotoxic crisis.

The primary cause of kilpnäärmekriis is an overproduction of thyroid hormones, thyroxine (T4) and triiodothyronine (T3). This excessive hormonal activity can be triggered by various factors, including infection, trauma, surgery, childbirth, or the abrupt cessation of antithyroid medication in individuals with hyperthyroidism.

Symptoms of kilpnäärmekriis are an exaggeration of typical hyperthyroid signs. These can include very high fever, rapid heart rate (tachycardia), irregular heartbeat (arrhythmia), extreme restlessness, confusion, delirium, agitation, and even coma. Gastrointestinal symptoms such as nausea, vomiting, diarrhea, and jaundice may also be present. The body's metabolism speeds up drastically, leading to dehydration, electrolyte imbalances, and heart failure.

Diagnosis is typically based on clinical presentation, considering the patient's history and physical examination findings. Laboratory tests may reveal significantly elevated levels of thyroid hormones and suppressed levels of thyroid-stimulating hormone (TSH).

Kilpnäärmekriis is a medical emergency requiring immediate hospitalization and intensive treatment. Management focuses on reducing thyroid hormone production and release, blocking the effects of excess hormones on the body, and addressing precipitating factors. This usually involves antithyroid medications, iodine solutions, beta-blockers, corticosteroids, and supportive care such as intravenous fluids and fever reduction. Prompt and aggressive treatment is crucial for survival and preventing long-term complications.