Apathetic thyrotoxicosis secondary to atypical subacute thyroiditis.

Abstract

OBJECTIVE:

To report a case of apathetic thyrotoxicosis with an etiology of subacute thyroiditis.

METHODS:

We describe the patient's clinical findings, laboratory findings, and clinical course.

RESULTS:

An 85-year-old woman with no history of thyroid disease presented with severe obtundation and altered mental status. Laboratory testing documented elevated free thyroxine and free triiodothyronine concentrations and a suppressed thyrotropin concentration. Thyroid antibodies were absent. A radioactive iodine study revealed severely diminished uptake, suggestive of thyroiditis. After a short course of steroids, the patient's mental status returned to baseline. Follow-up laboratory testing showed normalizing thyroid function.

CONCLUSION:

Even in the absence of a history of thyroid disease, we recommend considering thyroid dysfunction in the differential diagnosis of patients who present with altered mental status, particularly in the elderly population.

• Authors: Alessia L Carluccio, Nina K Sundaram, Robert T Yanagisawa, Yaron Tomer
• Journal: Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists (Endocr Pract) 2012 Sep-Oct Vol. 18 Issue 5 Pg. e127-9 ISSN: 1934-2403 [Electronic] United States
• PMID: 22548945 (Publication Type: Case Reports, Journal Article)

Topics

• Aged, 80 and over
• Female
• Humans
• Thyroiditis, Subacute (complications, diagnosis)
• Thyrotoxicosis (diagnosis, etiology)