Which of the following is a sign of thyrotoxic crisis in Graves' disease?

Which of the following is a sign of thyrotoxic crisis in Graves' disease?

• A. Pallor
• B. Bradycardia
• C. Fever
• D. Weight gain

Answer: (C)

Thyrotoxic crisis (thyroid storm) is an acute, life-threatening flare of Graves’ thyrotoxicosis driven by a massive rise in thyroid hormone and sympathetic nervous system activity. A defining feature is fever, because the extreme hypermetabolic state produces a lot more heat and the body's temperature regulation is overwhelmed. This fever often accompanies marked tachycardia, sweating, agitation, and potential delirium or other systemic effects, all reflecting the widespread acceleration of metabolism and adrenergic sensitivity. The other options don’t fit the typical picture: bradycardia would be opposite of the common rapid heart rate seen in thyroid storm, pallor is not a hallmark feature, and weight gain is unusual in thyrotoxicosis where weight loss is more common due to increased metabolism. Thus fever is the best sign of a thyrotoxic crisis.

Thyrotoxic crisis (thyroid storm) is an acute, life-threatening flare of Graves’ thyrotoxicosis driven by a massive rise in thyroid hormone and sympathetic nervous system activity. A defining feature is fever, because the extreme hypermetabolic state produces a lot more heat and the body's temperature regulation is overwhelmed. This fever often accompanies marked tachycardia, sweating, agitation, and potential delirium or other systemic effects, all reflecting the widespread acceleration of metabolism and adrenergic sensitivity.

The other options don’t fit the typical picture: bradycardia would be opposite of the common rapid heart rate seen in thyroid storm, pallor is not a hallmark feature, and weight gain is unusual in thyrotoxicosis where weight loss is more common due to increased metabolism. Thus fever is the best sign of a thyrotoxic crisis.