Thyroid crisis or storm was at one time a serious and not infrequent complication of thyroidectomy for hyperthyroidism. In 1934, Ransom27 reported 37 fatal cases occurring within a six-year period, accounting for 70% of the deaths associated with thyroid surgery at the University of Michigan prior to 1930. Reported mortality rates have varied from 50% to 100% amongst those developing the syndrome. Preoperative administration of iodine and antithyroid drugs have, however, reduced thyroid crisis to a relative rarity.20,25 Furthermore, when it does occur, newer therapeutic measures have reduced mortality significantly. Most recently this has been reported to be 25%.38
In the past ten years only two patients have developed thyroid crisis postoperatively at the University of Michigan Hospital. These two patients survived and form the basis of this report.
McArthur19 has defined thyroid crisis as a life endangering exacerbation of thyrotoxicosis. The clinical picture depends on