Deliberate self-harm in a patient with hyperthyroidism with acute psychosis.
BMJ Case Rep
; 14(10)2021 Oct 14.
Article
em En
| MEDLINE
| ID: mdl-34649855
ABSTRACT
A woman in her 30s with underlying Graves' disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient's own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transtornos Psicóticos
/
Neoplasias da Glândula Tireoide
/
Comportamento Autodestrutivo
/
Hipertireoidismo
Tipo de estudo:
Etiology_studies
Idioma:
En
Revista:
BMJ Case Rep
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Malásia