Propranolol is useful in the management of the cardiovascular and neuromuscular problems occurring in hyperthyroid patients.1,2 Propranolol has been used as the sole drug in preparation of patients for thyroidectomy,3,4 in the treatment of pregnant thyrotoxic patients5 6 7 and in neonatal thyrotoxicosis.8 Thyroid storm in both the adult9 and the child10 has been managed with propranolol in conjunction with specific antithyroid therapy. It has been assumed that propranolol will prevent thyroid storm.11 In the two patients described below, thyroid storm developed on seemingly adequate propranolol therapy for thyrotoxicosis. Case Report Case 1. A 24-year-old Mexican-American woman was admitted to Ben Taub.
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