Graves' Disease Complications: Thyroid Storm and Mortality Risk

Graves' disease (autoimmune hyperthyroidism) is usually manageable with antithyroid drugs, radioiodine, or surgery. However, thyroid storm (thyrotoxic crisis) is a life-threatening exacerbation.

Thyroid Storm

• Triggers: Infection, surgery, trauma, DKA, stroke, iodine load, non-adherence.
• Diagnosis (Burch-Wartofsky Score): Fever >40°C, tachycardia >140, CNS agitation/delirium, GI/hepatic dysfunction, precipitant history.
• Mortality: 10–30% even with ICU care; rapid progression to multi-organ failure.
• Treatment: High-dose PTU/methimazole + iodine (1h later) + beta-blockers + glucocorticoids + supportive care + treat trigger.

Other Risks

Atrial fibrillation → stroke; osteoporosis; Graves' ophthalmopathy (vision loss); dermopathy; agranulocytosis (drug side effect).

Close monitoring, adherence, and prompt care for fever/tachycardia/mental status changes prevent fatal outcomes.