Adolescent female patient with shock unresponsive to usual resuscitative therapy.

Thyroid storm (thyroid crisis) is a rare and serious complication of thyrotoxicosis with a significant mortality rate if left untreated. Early recognition of the syndrome with a thorough history and physical examination is therefore essential. The exact mechanism for this decompensation is unknown; however, many physiologic stressors can precipitate the crisis. This report describes an unusual case of a previously unrecognized thyrotoxicosis developing into a storm in a pediatric patient manifesting as refractory shock.