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Obiora Ogbuawa, MB, BS; Ronald Johnson, MD

Arch Intern Med. 1980;140(9):1245-1246.

Abstract
• A 32-year-old woman first had thyrotoxicosis and severe pernicious anemia (PA) in 1975. The initial serum thyroxine (T₄) level, 14.5 µg/dL, rose to 29.2 µg/dL, with no other therapy except cyanocobalamin injection and blood transfusions. She again had thyroid storm and PA in 1978. The serum T_, level was only slightly elevated, but the triiodothyronine (T₃) level was normal. She received therapy for both diseases and recovered. Four months later, with a normal hematocrit reading, thyrotoxicosis recurred, with noticeable elevation of T₄ and T₃. These data suggest that first, thyroid storm can occur with excess T₄ only, and its occurrence does not depend on the degree of thyroid hormone elevation; and second, thyroid hormone level may be depressed in severe PA, and a normal T₃ level should not rule out thyrotoxicosis in this condition.

(Arch Intern Med 140:1245-1246, 1980)

Author Affiliations
From the Section of Endocrinology and Metabolism, Howard Medical Service, District of Columbia General Hospital, Washington, DC.

Footnotes
Accepted for publication Dec 10, 1979.

Reprint requests to Howard Medical Service, District of Columbia General Hospital, Washington, DC 20003 (Dr Ogbuawa).

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