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Coma and thyroid storm in apathetic thyrotoxicosis
Michel W Ghobrial1, Edward B Ruby
1Department of Endocrinology, Mercy Catholic Medical Center, Darby, PA, USA.
Southern Medical Journal
|May 15, 2002
Summary
A rare case of apathetic hyperthyroidism leading to thyroid storm and coma in an elderly woman was documented. Prompt antithyroid therapy led to a full recovery, highlighting the importance of recognizing this severe presentation.
Area of Science:
- Endocrinology
- Geriatric Medicine
- Internal Medicine
Background:
- Thyrotoxic crisis, a life-threatening condition, can present atypically in the elderly.
- Apathetic hyperthyroidism is a variant characterized by blunted symptoms, often leading to delayed diagnosis.
Observation:
- An 87-year-old woman presented with coma and was diagnosed with thyrotoxic crisis.
- Her history included decreased mentation and apathy, with laboratory results confirming hyperthyroidism.
Findings:
- The patient experienced a severe clinical course but ultimately recovered to her baseline state.
- Antithyroid therapy normalized her laboratory values and improved her clinical condition.
Implications:
- This case highlights a rare presentation of apathetic hyperthyroidism with thyroid storm and coma.
- Recognizing and managing this severe endocrine emergency in the elderly is crucial for favorable outcomes.