Psychostic disorder as the first manifestation of myxedema: A case report
Main Article Content
Abstract
Myxedema coma is severe and life-threatening. This condition represents a state of long-lasting, unrecognized or poorly controlled thyroid hypofunction. Occasionally these patients first receive a diagnosis of a mental disorder. A case of acute psychosis is presented in a 51-year-old woman, with no history of mental disorder as the initial manifestation of myxedema. In patients with acute psychosis, evaluation of thyroid function is imperative. Treatment includes thyroid hormone replacement and short-term antipsychotics. It is crucial to consider thyroid etiology in cases of acute psychoses.
Downloads
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
References
Klubo-Gwiezdzinska J, Wartofsky L. Thyroid emergencies. Med Clin North Am. 2012;96(2):385-403. http://dx.doi.org/10.1016/j.mcna.2012.01.015
Rodríguez I, Fluiters E, Pérez-Méndez LF, Luna R, Páramo C, García-Mayor RV. Factors associated with mortality of patients with myxoedema coma: Prospective study in 11 cases treated in a single institution. J Endocrinol. 2004;180(2):347-350. http://dx.doi.org/10.1677/joe.0.1800347
Ono Y, Ono S, Yasunaga H, Matsui H, Fushimi K, Tanaka Y. Clinical characteristics and outcomes of myxedema coma: Analysis of a national inpatient database in Japan. J Epidemiol. 2017;27(3):117-122. http://dx.doi.org/10.1016/j.je.2016.04.002
Chiong YV, Bammerlin E, Mariash CN. Development of an objective tool for the diagnosis of myxedema coma. Transl Res. 2015;166(3):233-243. http://dx.doi.org/10.1016/j.trsl.2015.01.003
Heinrich TW, Grahm G. Hypothyroidism presenting as psychosis: myxedema madness revisited. Prim Care Companion J Clin Psychiatry. 2003;5(6):260-266. http://dx.doi.org/10.4088/pcc.v05n0603
Azzopardi L, Murfin C, Sharda A, De Silva N. Myxoedema madness. BMJ Case Rep. 2010;1-3. http://dx.doi.org/10.1136/bcr.03.2010.2841
Pomeranze J, King E. Psychosis as first sign of thyroid dysfunction. Geriatrics. 1966;21(6):211-212. http://dx.doi.org/10.4088/pcc.v05n0603
Ueno S, Tsuboi S, Fujimaki M, Eguchi H, Machida Y, Hattori N, et al. Acute psychosis as an initial manifestation of hypothyroidism: A case report. J Med Case Rep. 2015;9(1):1-3. http://dx.doi.org/10.1186/s13256-015-0744-z
Chaker L, Bianco AC, Jonklaas J, Peeters RP. Hypothyroidism. Lancet. 2017;390(10101):155-1562. http://dx.doi.org/10.1016/S0140-6736(17)30703-1
Morosán-Allo YJ, Rosmarin M, Urrutia A, Faingold MC, Musso C, Brenta G. Myxedema madness complicating postoperative follow-up of thyroid cancer. Arch Endocrinol Metab. 2015;59(4):359-363. http://dx.doi.org/10.1590/2359-3997000000090
Feldman AZ, Shrestha RT, Hennessey J V. Neuropsychiatric Manifestations of thyroid disease. Endocrinol Metab Clin North Am. 2013;42(3):453-476. http://dx.doi.org/10.1016/j.ecl.2013.05.005
Sardar S, Habib MB, Sukik A, Tanous B, Mohamed S, Tahtouh R et al. Myxedema Psychosis: Neuropsychiatric manifestations and rhabdomyolysis unmasking hypothyroidism. Case Rep Psychiatry. 2020;2020:7801953. http://dx.doi.org/10.1155/2020/7801953
Van Vliet NA, Van Heemst D, Almeida OP, Åsvold BO, Aubert CE, Bae JB, et al. Thyroid studies collaboration. Association of thyroid dysfunction with cognitive function: An individual participant data analysis. JAMA Intern Med. 2021;181(11):1440-1450. http://dx.doi.org/ 10.1001/jamainternmed.2021.5078.
Fernández-Lamo I, Montero-Pedrazuela A, Delgado-García JM, Guadaño-Ferraz A, Gruart A. Effects of thyroid hormone replacement on associative learning and hippocampal synaptic plasticity in adult hypothyroid rats. Eur J Neurosci. 2009;30(4):679-692. http://dx.doi.org/10.1111/j.1460-9568.2009.06862.x
Koromilas C, Liapi C, Schulpis KH, Kalafatakis K, Zarros A, Tsakiris S. Structural and functional alterations in the hippocampus due to hypothyroidism. Metab Brain Dis. 2010;25(3):339-354. http://dx.doi.org/10.1007/s11011-010-9208-8
Mavroson MM, Patel N, Akker E. Myxedema psychosis in a patient with undiagnosed hashimoto thyroiditis. J Am Osteopath Assoc. 2017;117(1):50-54. http://dx.doi.org/10.7556/jaoa.2017.007
Hawatmeh A, Thawabi M, Abuarqoub A, Shamoon F. Amiodarone induced myxedema coma: Two case reports and literature review. Heart Lung. 2018;47(4):429-431. http://dx.doi.org/10.1016/j.hrtlng.2018.03.012
Ylli D, Klubo‑Gwiezdzinska J, Wartofsky L. Thyroid emergencies. Polish Arch Intern Med. 2019;129(7–8):526-534. http://dx.doi.org/10.20452/pamw.14876
Popoveniuc G, Chandra T, Sud A, Sharma M, Blackman MR, Burman KD, et al. A diagnostic scoring system for myxedema coma. Endocr Pract. 2014;20(8):808-817. http://dx.doi.org/10.4158/EP13460.OR
Kwaku MP, Burman KD. Myxedema coma. J Intensive Care Med. 2007;22(4):224-231. http://dx.doi.org/10.1177/0885066607301361