RT Journal
T1 WEathering the thyrotoxic storm
JF JAMA
JO JAMA
YR 1969
FD December 8
VO 210
IS 10
SP 1914
OP 1915
DO 10.1001/jama.1969.03160360060015
UL http://dx.doi.org/10.1001/jama.1969.03160360060015
AB Untreated thyroid storm is a uniformly lethal complication of thyrotoxicosis. For a number of years mortality has remained high despite suppression of thyroid hormone production by thiourea drugs, inhibition of its release by iodides, control of pyrexia by hypothermia, and supportive therapy by appropriate fluid and electrolytes. The addition of hydrocortisone to the therapeutic regimen has helped reduce mortality. But only with the recent introduction of adrenolytic drugs, and currently of betaadrenergic blocking agents in the treatment of this critical emergency, did the prognosis improve substantially.Increased sympathetic activity in thyrotoxicosis, first demonstrated by Brewster and co-workers,1 provided a rationale for the use of adrenolytic drugs in thyroid storm. The drug most commonly used has been reserpine, which is known to cause depletion of tissue catecholamines and depression of consciousness. In a recent issue of the Archives of Internal Medicine, Mazzaferri and Skillman2 report good results with guanethidine