Recognizing thyrotoxicosis in a patient with bipolar mania: a case report

Area of Science:

• Endocrinology
• Psychiatry
• Neuroscience

Background:

• Thyroid stimulating hormone (TSH) levels are routinely checked in patients with mania symptoms to exclude medical conditions like hyperthyroidism.
• Cases exist where patients are treated for bipolar mania but later diagnosed with thyroid disorders.
• Thyroid conditions have been reported in bipolar patients during or after lithium treatment.

Purpose of the Study:

• To present a case of bipolar disorder with comorbid hyperthyroidism and mania following lithium discontinuation.
• To highlight the importance of considering thyroid dysfunction in specific patient populations.

Main Methods:

• Case review of a patient with a history of bipolar disorder.
• Analysis of clinical presentation including manic symptoms and hyperthyroidism.
• Examination of treatment response after lithium discontinuation.

Main Results:

• The patient presented with bipolar mania and hyperthyroidism concurrently.
• The condition emerged after the recent cessation of lithium treatment.
• This case underscores the complex interplay between thyroid status and mood disorders.

Conclusions:

• Consider comorbid hyperthyroidism in bipolar manic patients with partial response to standard mood stabilizers and antipsychotics.
• Routine thyroid screening may be beneficial in select bipolar disorder patients.
• Early identification and management of thyroid dysfunction are essential for effective psychiatric treatment.