Management of a female patient with thyroid storm accompanied by acute airway obstruction: A case report

Thyroid storm (TS) is a life-threatening exacerbation of the hyperthyroid state. Acute airway obstruction is a life-threatening disease that requires emergency intervention. The present report describes a case of concomitant TS (Burch-Wartofsky Point Scale score, 70 points; thyroid-stimulating hormone, <0.01 µIU/ml; free triiodothyronine, 30.8 pmol/l; and free thyroxine, 106.7 pmol/l) and acute airway obstruction in a 63-year-old female patient. Although treating the TS was viewed as the primary medical concern, the airway obstruction induced by the large thyroid also needed to be solved urgently. In the present case, thyroidectomy was immediately performed, following which the TS was controlled by medical treatment (propylthiouracil, sodium iodide, hydrocortisone and esmolol). After the surgery, the airway obstruction and TS were alleviated, before the patient was eventually discharged from the hospital 14 days after surgery. At 1 month after discharge from the hospital, the patient had normal thyroid function with oral intake of levothyroxine tablet and did not complain of dyspnoea. The present case report aims to emphasize the need for the heightened awareness of patients with TS and trachea stenosis, and underscore the importance of solving the airway obstruction accompanying the TS.