Case report: pseudoephedrine-associated thyroid storm: thyroid hormone-catecholamine interactions.

Thyroid storm is an increasingly rare, life-threatening manifestation of thyrotoxicosis that can be precipitated by many physiologic stressors. The exact mechanism by which thyrotoxicosis decompensates into thyroid storm in certain individuals is unknown. These individuals may have an enhanced cellular sensitivity to either catecholamines or thyroid hormone. Serum levels of catecholamines are usually low or normal in thyrotoxic individuals. Ingestion of sympathomimetic drugs in thyrotoxic individuals may precipitate thyroid storm. This article presents an unusual case of Graves' disease that decompensated into thyroid storm after the ingestion of an over-the-counter cold medication containing pseudoephedrine.