Case Report
Volume: 7 | Issue: 5 | Published: Aug 01, 2023 | Pages: 115 - 117 | DOI: 10.24911/ejmcr/173-1675543271
Severe acute myxedematous psychosis; rare complication of hypothyroidism
Authors: Hasnae Guerrouj , Ghizlane Ennibi
Article Info
Authors
Hasnae Guerrouj
Nuclear Medicine Department, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
Ghizlane Ennibi
Oncology Centre of Hospital Hassan II, Agadir, Morocco.
Publication History
Received: February 05, 2023
Revised: April 21, 2023
Accepted: April 21, 2023
Published: August 01, 2023
Abstract
Background: Severe acute myxedematous psychosis, or myxedema madness, is a rare and serious psychiatric complication of hypothyroidism. It is most often misdiagnosed, but it remains reversible after treatment with thyroid hormones. Case Presentation: We report a case of a patient without a known past medical history who underwent total thyroidectomy for papillary thyroid carcinoma. During her withdrawal from thyroid hormone therapy to perform a diagnostic radioiodine wholebody scintigraphy, she presented with anxiety, delirium, and hallucinations, culminating in a suicide attempt. Laboratory testing revealed a high sensible-thyroid stimulating hormone (TSH) value of 35 µIU/ml. The patient was hospitalized in a psychiatric unit, where she received antipsychotic medication and was started on thyroid hormones. After a week, there was a dramatic improvement. Psychiatric symptoms were completely gone a month later justifying the discontinuation of antipsychotics. Recombinant human TSH (rh-TSH) was necessary injected before radioiodine therapy to avoid thyroid hormone therapy suppression and to prevent a second episode of acute psychosis. Conclusion: rh-TSH interest is both in the pre Ira therapy stimulation and for the post-treatment monitoring of patients with thyroid cancer, and helps avoiding hormonal treatment suppression.
Keywords: Myxedema, psychosis, hypothyroidism, carcinoma, rhTSH, green
Pubmed Style
Hasnae Guerrouj, Ghizlane Ennibi. Severe acute myxedematous psychosis; rare complication of hypothyroidism. EJMCR. 2023; 01 (August 2023): 115-117. doi:10.24911/ejmcr/173-1675543271
Web Style
Hasnae Guerrouj, Ghizlane Ennibi. Severe acute myxedematous psychosis; rare complication of hypothyroidism. https://ejmcr.com/articles/1057 [Access: December 04, 2024]. doi:10.24911/ejmcr/173-1675543271
AMA (American Medical Association) Style
Hasnae Guerrouj, Ghizlane Ennibi. Severe acute myxedematous psychosis; rare complication of hypothyroidism. EJMCR. 2023; 01 (August 2023): 115-117. doi:10.24911/ejmcr/173-1675543271
Vancouver/ICMJE Style
Hasnae Guerrouj, Ghizlane Ennibi. Severe acute myxedematous psychosis; rare complication of hypothyroidism. EJMCR. (2023), [cited December 04, 2024]; 01 (August 2023): 115-117. doi:10.24911/ejmcr/173-1675543271
Harvard Style
Hasnae Guerrouj, Ghizlane Ennibi (2023) Severe acute myxedematous psychosis; rare complication of hypothyroidism. EJMCR, 01 (August 2023): 115-117. doi:10.24911/ejmcr/173-1675543271
Chicago Style
Hasnae Guerrouj, Ghizlane Ennibi. "Severe acute myxedematous psychosis; rare complication of hypothyroidism." 01 (2023), 115-117. doi:10.24911/ejmcr/173-1675543271
MLA (The Modern Language Association) Style
Hasnae Guerrouj, Ghizlane Ennibi. "Severe acute myxedematous psychosis; rare complication of hypothyroidism." 01.August 2023 (2023), 115-117. Print. doi:10.24911/ejmcr/173-1675543271
APA (American Psychological Association) Style
Hasnae Guerrouj, Ghizlane Ennibi (2023) Severe acute myxedematous psychosis; rare complication of hypothyroidism. , 01 (August 2023), 115-117. doi:10.24911/ejmcr/173-1675543271