Shock thyroid is an uncommon part of the hypovolemic shock complex.
It was initially described in 2016 as heterogenous thyroid contrast enhancement and fluid surrounding the thyroid in trauma CT of shocked patients without evidence for direct thyroid injury 2. Only 7 cases have been described as of June 2017 1, 2. It is probably under-recognised but currently it is unknown where there are any clinical implications in the shocked patient.
It is hypothesised that shock thyroid results from a combination of hypoperfusion of the thyroid gland causing intracellular edema and death and a transient thyrotoxicosis in response to the hypovolemia 2. Most cases described are due to shock secondary to trauma.
In the absence of evidence of direct thyroid injury, the thyroid may be enlarged with heterogenous contrast enhancement which may mimic a multinodular gland. Low density fluid tracks around the thyroid with density of -5 to 10 HU 1. Typically there are other signs of the hypovolemic shock complex in the chest and abdomen.
- 1. Han DH, Ha EJ, Sun JS, Jung SL. Remarkable CT features of shock thyroid in traumatic and non-traumatic patients. Emergency radiology. 24 (3): 319-324. doi:10.1007/s10140-016-1475-1 - Pubmed
- 2. Brochert A, Rafoth JB. Shock thyroid: A new manifestation of the hypovolemic shock complex in trauma patients. Journal of computer assisted tomography. 30 (2): 310-2. Pubmed