From Functional Disorder to a Life-Threatening Emergency: A Rare Adolescent Case of Thyrotoxicosis

TL;DR

A 16-year-old with untreated Graves' disease developed a life-threatening thyroid storm triggered by influenza, highlighting the need for early diagnosis and management.

Contribution

This case emphasizes the rare but severe progression of thyrotoxicosis to thyroid storm in adolescents and the role of infection as a precipitating factor.

Findings

Thyroid storm was confirmed in a 16-year-old with untreated Graves' disease.

Influenza B infection acted as a precipitating factor for the thyroid storm.

Antithyroid therapy and intensive care improved the patient's condition.

Abstract

Thyroid storm is a rare but life-threatening endocrine emergency that requires rapid recognition and multidisciplinary care. We report the case of a 16-year-old female patient admitted to the emergency department with acute confusion, fever, and tachycardia, in whom severe thyrotoxicosis was confirmed. Her Burch-Wartofsky score was 40, consistent with an impending thyroid storm. Graves’ disease had been previously diagnosed, but treatment was delayed, and influenza B infection acted as a precipitating factor. Management with antithyroid drugs, beta-blockers, and intensive care led to clinical improvement, with thyroidectomy subsequently planned. This case highlights the importance of early diagnosis, coordinated management, and awareness of infection as a trigger, while emphasizing the limitations of antithyroid therapy in adolescents.

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