Abstract 143: the Tale of Three Ladies with Thyrotoxic Storms

Introduction: Patient A. 35 year old female presenting with jaundice and thyrotoxic crisis. Patient B. 28 year old female presenting with decompensated heart failure and thyrotoxic crisis Patient C. 36 year old female presenting with Diabetic Ketoacidosis and thyrotoxic crisis. Aims and Objectives: To sensitize the treating team in utilization of the Burch-Wartofsky scoring system to better diagnose and manage cases of thyrotoxicosis. Results: Patient A presented to the surgical department with abdominal pain, fever and jaundice. Incidentally detected to have a grade 2 goiter and tachycardia with thyrotoxicosis with a Burch-Wartofsky score of 52. Patient B, known case of Graves’ disease of 1 year, presented to the cardiology department with decompensated heart failure with a history of non-compliance to treatment, with Burch-Wartofsky score of 47. Patient C, known case of Graves’ disease since 3 years with T1DM, poorly controlled on anti-thyroid drugs with day 3 post-RAIA, presenting with Diabetic ketoacidosis and Burch-Wartofsky score of 62. Conclusion: Prompt endocrinology consultations enabled the treating teams to diagnose these life threatening presentations of thyrotoxicosis utilizing the scoring system and instituting appropriate management strategies with successful outcomes.