Thyroid storm is a life-threatening condition of the hyperthyroid state. 26 It most commonly occurs in patients with Graves' disease but may also occur in those with multinodular goiter or toxic adenoma. 27 It is treated by correcting the hyperthyroidism and treating the precipitating events. 26 Correction of the hyperthyroid state involves using drugs such as propylthiouracil or methimazole (Tapazole), beta blockers or corticosteroids, which decrease the peripheral effects of thyroid hormone and the conversion of thyroxine (T 4 ) to the more potent triiodothyronine (T 3 ). 22 , 26 Dexamethasone can be used for that purpose, at a dosage of 2 mg intravenously every six hours, and can eventually can be switched to an oral dosage of 2 mg every six hours. 28
Steroids killed nine-year-old Lexie McConnell after only five and a half weeks. In August 1993, Lexie was diagnosed as having toxoplasmosis. The consultant put her on 80 mg per day of prednisolone. Immediately, she suffered severe side effects, huge weight gain , terrible pains, holes in her tongue and black stools. After nearly a month, at her parents' pleading, the doctors quickly lowered the dosage to 60 mg, 40 mg, 20 mg. In excruciating pain, Lexie was taken to a hospital, where it was discovered she'd contracted chickenpox. Four days later, she died. A few years later, another eye specialist declared that a simple course of antibiotics could have cleared up her infection. The above excerpt is from Ursula Kelly's site
We identified seven trials, with 895 evaluable participants for this review . All provided data suitable for the primary outcome meta-analysis . One of the trials was new since the last version of this Cochrane systematic review . Risk of bias in the older, smaller studies included some unclear- or high- risk assessments, whereas we deemed the larger studies at low risk of bias . Overall, 79/452 (17%) participants allocated to corticosteroids had incomplete recovery of facial motor function six months or more after randomisation ; significantly fewer than the 125/447 (28%) in the control group ( risk ratio ( RR ) , 95% confidence interval ( CI ) to , seven trials, n = 895). The number of people who need to be treated with corticosteroids to avoid one incomplete recovery was 10 (95% CI 6 to 20). The reduction in the proportion of participants with cosmetically disabling sequelae six months after randomisation was very similar in the corticosteroid and placebo groups ( RR , 95% CI to , two trials, n = 75, low-quality evidence). However, there was a significant reduction in motor synkinesis during follow-up in participants receiving corticosteroids ( RR , 95% CI to , three trials, n = 485, moderate-quality evidence). Three studies explicitly recorded the absence of adverse effects attributable to corticosteroids. One trial reported that three participants receiving prednisolone had temporary sleep disturbances and two trials gave a detailed account of adverse effects occurring in 93 participants, all non-serious; the combined analysis of data from these three trials found no significant difference in adverse effect rates between people receiving corticosteroids and people receiving placebo ( RR , 95% CI to , n = 715).