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Hypothyroidism Revealed During General Anesthesia in a Patient With Treatment-Resistant Depression: A Case Report
Anesthesia Progress
|July 14, 2025
Summary
Undiagnosed hypothyroidism can cause serious complications during general anesthesia. This case highlights detecting hypothyroidism intraoperatively in a patient with treatment-resistant depression, likely due to lithium carbonate.
Area of Science:
- Anesthesiology
- Endocrinology
- Psychiatry
Background:
- General anesthesia in undiagnosed hypothyroidism poses risks.
- Treatment-resistant depression can mask hypothyroid symptoms.
Observation:
- A patient undergoing surgery presented with unexplained hypotension, bradycardia, hypothermia, and low bispectral index.
- These signs persisted despite anesthetic adjustments, prompting further investigation.
Findings:
- Intraoperative thyroid function tests revealed previously undiagnosed hypothyroidism.
- Lithium carbonate was identified as the probable causative agent.
Implications:
- Hypothyroidism can be overlooked in patients with depression due to overlapping symptoms.
- Clinical suspicion during anesthesia is crucial for timely diagnosis.
- Consider hypothyroidism in patients on lithium carbonate, especially with unexplained anesthetic complications.
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