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Thyroid Storm Aspirin Avoidance — RACP Adult Medicine MCQ

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ModerateEmergency MedicineThyroid Storm Aspirin AvoidanceRACP Adult Medicine

A 40-year-old woman with known Graves' develops thyroid storm: fever 41°C, HR 160, AF, confusion. On IV propranolol, PTU, Lugol's, hydrocortisone. Temperature remains critically high. Which antipyretic must be AVOIDED?

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Correct answer: CAspirin

Aspirin CONTRAINDICATED in thyroid storm: displaces T3/T4 from TBG, increasing free hormone levels. Use paracetamol + active cooling.

Reference: eTG – 2025 – Endocrinology; ATA – 2016