Thyroid storm is an important endocrine emergency. Suspect the condition in any severely ill patient with tachycardia, high fever and a thyroid swelling. Early treatment with antithyroid drugs, iodine, steroids, b-blockers and supportive measures reduces mortality. Treatment of the precipitating factors is also important. Once treated for the acute problem, don’t forget the long-term management of thyrotoxicosis.

Remember 5 B’s in management - Block Synthesis - Antithyroid drugs; Block Releasers - Iodine; Block T4 to T3 conversion - Propylthiouracil (PTU), Steroids; Beta-blockers - for symptomatic relief; Block enterohepatic circulation - Cholestyramine.