Undiagnosed Thyrotoxicosis in a Pregnant Woman with Spontaneous Renal Artery Aneurysm Rupture

Renal artery aneurysm (RAA) rupture during pregnancy is a rare event which is associated with high mortality rates for both mother and fetus. Hyperthyroidism may be present during pregnancy. Both complications are easily confused with more common conditions. We report an unusual case of a pregnant woman with undiagnosed hyperthyroidism and spontaneous RAA rupture. Thyroid storm may have been precipitated by the RAA rupture; however, the diagnosis was delayed because signs and symptoms were mistaken for those of hypovolemia. The possibility of thyrotoxicosis should be considered when mental status changes and tachycardia persist after the treatment of hypovolemic shock.