Thyrotoxic vomiting. A case report

Area of Science:

• Endocrinology
• Internal Medicine
• Thyroidology

Background:

• Thyrotoxicosis can present with atypical symptoms, particularly in postmenopausal women.
• Severe vomiting and weight loss may be the primary manifestations of hyperthyroidism.
• Subtle or absent classic signs of thyrotoxicosis can complicate diagnosis.

Observation:

• A postmenopausal female presented with severe vomiting and significant weight loss.
• Laboratory tests revealed elevated thyroid hormone levels, suggestive of thyrotoxicosis.
• Classic signs and symptoms of thyrotoxicosis were not apparent at the time of initial presentation.

Findings:

• Antithyroid therapy using carbimazole and propranolol led to rapid symptom resolution.
• The patient experienced marked improvement in her overall well-being following initial treatment.
• Subsequent radioactive iodine ablation of the thyroid gland resulted in a long-term asymptomatic state.

Implications:

• This case highlights the importance of considering thyrotoxicosis in postmenopausal women presenting with unexplained vomiting and weight loss, even without overt thyrotoxic symptoms.
• Early and appropriate medical management, followed by definitive therapy, can effectively control severe thyrotoxicosis.
• The successful treatment strategy underscores the efficacy of a multi-modal approach in managing complex thyroid disorders.