Prolonged ventilation in thyroid storm

Thyroid storm (crisis) is uncommon but may be life threatening and is recognised by an exaggeration of the clinical features of thyrotoxicosis. Proximal myopathy is a well recognised presenting feature of Graves disease. Respiratory muscle weakness may also commonly occur in thyrotoxicosis but is often undiagnosed. We report a case of thyroid storm with rapid atrial fibrillation, severe agitation and extreme widespread muscle weakness. The respiratory muscles were so compromised that a respiratory arrest occurred. Ventilation was required for 7 weeks until full recovery occurred.