Myxedema madness complicating postoperative follow-up of thyroid cancer.
نویسندگان
چکیده
Although hypothyroidism is associated with an increased prevalence of psychiatric manifestations, myxedema madness is rarely observed. We report the case of a 62-year-old woman with no prior history of psychiatric disorders, who presented to the emergency department with psychomotor agitation 6 weeks after total thyroidectomy for papillary thyroid cancer. Serum thyroid stimulating hormone (TSH) on admission was 62.9 mIU/L and free T4 was < 0.35 ng/dL, indicating severe hypothyroidism. After ruling out other possible causes, the diagnosis of myxedema madness was considered; hence, antipsychotic drug treatment and intravenous levothyroxine were prescribed. Behavioral symptoms returned to normal within 4 days of presentation, while levels of thyroid hormones attained normal values 1 week after admission. Recombinant TSH (Thyrogen®) was used successfully to prevent new episodes of mania due to thyroid hormone withdrawal in further controls for her thyroid cancer. This case illustrates that myxedema madness can occur in the setting of acute hypothyroidism, completely reverting with levothyroxine and antipsychotic treatment. Recombinant TSH may be a useful tool to prevent myxedema madness or any severe manifestation of levothyroxine withdrawal for the follow-up of thyroid cancer.
منابع مشابه
Myxedema madness rapidly reversed with levothyroxine.
To the Editor: " Myxedema madness " is a severe, complicated form of psychosis due to significant hypothyroidism. Although literature exists illustrating psychiatric symptoms (eg, depression , lethargy) as a result of hypothyroidism, psychosis associated with hypothyroidism is often overlooked. Additionally, published literature varies on the nature of psychotic symptoms present (eg, Capgras sy...
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INTRODUCTION Hypothyroidism is one of the most important causes of treatable dementia, and psychosis occasionally associated with it is known as myxedema madness. We report a case of a 90-year-old patient who developed myxedema madness acutely without overt clinical symptoms and signs suggestive of hypothyroidism. CASE PRESENTATION A 90-year-old Japanese man, a general practitioner, was admit...
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Hypothyroidism is a medical condition commonly encountered in a variety of clinical settings. The clinical presentations of thyroid hormone deficiency are diverse, complicated, and often overlooked. Hypothyroidism is a potential etiology for multiple somatic complaints and a variety of psychological disturbances. The physical complaints are primarily related to metabolic slowing secondary to la...
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ورودعنوان ژورنال:
- Archives of endocrinology and metabolism
دوره 59 4 شماره
صفحات -
تاریخ انتشار 2015