Andrew J Gonedes, Aleksandr Butovskiy, Leon Melnitsky
Thyroid storm is a life-threatening complication of severe thyrotoxicosis, with significant mortality if not promptly recognized and treated. Stimulant drugs, including cocaine, may precipitate thyroid storm by amplifying catecholaminergic activity in susceptible individuals. We present the case of a 32-year-old woman with no known history of thyroid disease who developed thyroid storm following a week of intermittent cocaine use. Laboratory evaluation revealed profound thyrotoxicosis, markedly elevated thyroid antibodies, and features consistent with underlying autoimmune hyperthyroidism. Her Burch-Wartofsky score was 50, confirming thyroid storm. She was treated with propylthiouracil (PTU), hydrocortisone, beta-blockade, and supportive therapy, with rapid clinical improvement. This case highlights the importance of considering stimulant-induced triggers of thyroid storm, particularly among young patients without known thyroid disorders.