What is the role of lab tests in the workup of thyroid storm?

Updated: Mar 16, 2020
  • Author: Madhusmita Misra, MD, MPH; Chief Editor: Robert P Hoffman, MD  more...
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Answer

Results of thyroid studies are usually consistent with hyperthyroidism and are useful only if the patient has not been previously diagnosed.

  • Test results may not come back quickly and are usually unhelpful for immediate management.

  • Usual findings include elevated triiodothyronine (T3), thyroxine (T4), and free T4 levels; increased T3 resin uptake; suppressed thyroid-stimulating hormone (TSH) levels; and an elevated 24-hour iodine uptake. TSH levels are not suppressed in the rare instances of excess TSH secretion.

  • CBC count: CBC count reveals mild leukocytosis, with a shift to the left.

  • Liver function tests (LFTs): LFTs commonly reveal nonspecific abnormalities such as elevated levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatinine kinase, alkaline phosphatase, and serum bilirubin.

  • ABG and urinalysis: Measurement of blood gas and electrolyte levels and urinalysis testing may be performed to assess and monitor short-term management.

  • Hypercalcemia may occur from thyrotoxicosis.


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