Corrigendum to: 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis

Abstract

Ross DS, Burch HB, Cooper DS, et al. 2016. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid 26: 1343–1421. DOI: 10.1089/thy.2016.0229.

Table 6 in these guidelines has been updated to reflect the following corrections. Under Thermoregulatory Dysfunction, centigrade values have been moved from the footnote into the table, and any overlapping values have been removed for clarity. The previously missing “Impending storm” value has also been added. To match the original version of the table, the Precipitant History values that had been reversed have been updated. Under Congestive Heart Failure, the examples in parentheses have been reinstated, and the original footnote has been restored. The corrected version of Table 6 is provided below, and the online version has been updated.

Table 6.

Point Scale for the Diagnosis of Thyroid Storm^a

Criteria	Points	Criteria	Points
Thermoregulatory dysfunction		Gastrointestinal-hepatic dysfunction
Temperature °F (°C)		Manifestation
99.0–99.9 (37.2–37.7)	5	Absent	0
100.0–100.9 (37.8–38.3)	10	Moderate (diarrhea, abdominal pain, nausea/vomiting)	10
101.0–101.9 (38.4–38.8)	15	Severe (jaundice)	20
102.0–102.9 (38.9–39.4)	20
103.0–103.9 (39.5–39.9)	25
≥104.0 (≥40)	30
Cardiovascular dysfunction		Central nervous system disturbance
Tachycardia		Manifestation
90–109	5	Absent	0
110–119	10	Mild (agitation)	10
120–129	15	Moderate (delirium, psychosis, extreme lethargy)	20
130–139	20	Severe (seizure, coma)	30
≥140	25
Congestive Heart Failure		Precipitant history
Absent	0	Status
Mild (pedal edema)	5	Negative	0
Moderate (bibasilar rales)	10	Positive	10
Severe (pulmonary edema)	15
Atrial fibrillation
Absent	0
Present	10
Scores totaled
≥45	Thyroid storm
25–44	Impending storm
<25	Storm unlikely

In patients with severe thyrotoxicosis, points are assigned to the highest weighted description in each category and scores totaled. When it is not possible to distinguish the effects of an intercurrent illness from those of the severe thyrotoxicosis per se, points are awarded such as to favor the diagnosis of storm and hence, empiric therapy. A score of 45 or greater is highly suggestive of thyroid storm; a score of 25–44 is suggestive of impending thyroid storm, and a score below 25 is unlikely to represent thyroid storm. Source: Burch and Wartofsky.²⁶ Printed with permission.