Thyroid storm is a sudden, life-threatening exacerbation of
thyrotoxicosis. The classic clinical presentation includes fever,
tachycardia, tremor, nausea and vomiting, diarrhea, dehydration,
delirium, and coma.1The most characteristic feature is
fever, where the temperature may rise above 40.6°C (105°F).
Apathetic storm, which refers to a syndrome sometimes seen in elderly
patients, is characterized by extreme weakness and emotional
apathy.2Fever, if present, does not reach the levels seen
in classic storm. Variable presentations of typical hypermetabolic
thyroid storm have also been reported, and these include congestive
heart failure, hepatic failure, cerebral infarction, acute abdominal
pain, seizures, stroke, rhabdomyolysis, coma, and
shock.3–9 However, this is the first reported case of a
young patient presenting with normothermic, normotensive thyroid storm
accompanied by lactic acidosis and multiple organ dysfunction syndrome.