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Published on: March 17, 2023
Apathetic thyrotoxicosis secondary to atypical subacute thyroiditis
Alessia L Carluccio1, Nina K Sundaram, Robert T Yanagisawa
1Department of Medicine, Mount Sinai School of Medicine, New York, New York 10029, USA. Alessia.Carluccio@mountsinai.org
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.
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