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"Thyrotoxic psychosis" associated with subacute thyroiditis.

Ali A Rizvi1

  • 1Division of Endocrinology, Diabetes, and Metabolism, University of South Carolina School of Medicine, Columbia, SC, USA. arizvi@gw.mp.sc.edu

Southern Medical Journal
|August 24, 2007
PubMed
Summary
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Subacute thyroiditis can cause severe psychiatric symptoms like psychosis and depression. These behavioral changes resolved as the patient's thyroid function normalized, highlighting a rare but important clinical association.

Area of Science:

  • Endocrinology
  • Psychiatry
  • Thyroidology

Background:

  • Graves disease and toxic goiter are known causes of psychiatric disturbances.
  • Psychiatric manifestations are rare in thyroid disorders, often overlooked.
  • Subacute thyroiditis is an inflammatory thyroid condition with transient thyrotoxicosis.

Observation:

  • An 18-year-old male presented with severe depression and psychotic behavior.
  • Thyrotoxicosis was diagnosed, linked to subacute thyroiditis.
  • Diagnostic evidence included reduced radioactive iodine uptake and elevated thyroglobulin.

Findings:

  • The patient experienced spontaneous remission of thyrotoxicosis, transitioning to a hypothyroid phase.
  • Psychiatric symptoms completely resolved with the normalization of thyroid function.

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  • This case represents the first documented instance of self-limited subacute thyroiditis causing thyrotoxic psychosis.

    • Implications:

    • Clinicians should consider subacute thyroiditis in patients presenting with unexplained psychiatric symptoms.
    • Early diagnosis and management of thyroid dysfunction are crucial for resolving psychiatric derangements.
    • This case underscores the complex interplay between thyroid health and mental well-being.