The Delayed Diagnosis of Thyroid Storm in Patients with Psychosis: A Report of Two Cases

Yuki Ishihara; Taku Sugawa; Hiroki Kaneko; Kaho Hiroshima-Hamanaka; Aya Amano; Hironobu Umakoshi; Mika Tsuiki; Toru Kusakabe; Noriko Satoh-Asahara; Akira Shimatsu; Tetsuya Tagami

doi:10.2169/internalmedicine.2681-19

This article has now been updated. Please use the final version.

The Delayed Diagnosis of Thyroid Storm in Patients with Psychosis: A Report of Two Cases

Yuki Ishihara, Taku Sugawa, Hiroki Kaneko, Kaho Hiroshima-Hamanaka, Aya Amano, Hironobu Umakoshi, Mika Tsuiki, Toru Kusakabe, Noriko Satoh-Asahara, Akira Shimatsu, Tetsuya Tagami

Author information

Yuki Ishihara
Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
Taku Sugawa
Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
Hiroki Kaneko
Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
Kaho Hiroshima-Hamanaka
Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
Aya Amano
Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
Hironobu Umakoshi
Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
Mika Tsuiki
Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
Toru Kusakabe
Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
Noriko Satoh-Asahara
Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
Akira Shimatsu
Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan
Tetsuya Tagami
Department of Endocrinology and Metabolism, National Hospital Organization Kyoto Medical Center, Japan
Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Japan

Keywords: thyroid storm, Graves' disease, central nervous system, psychosis

JOURNAL OPEN ACCESS Advance online publication

Article ID: 2681-19

DOI https://doi.org/10.2169/internalmedicine.2681-19

The final version of this article is now available: Vol. 58 (2019), No. 15 pp. 2195-2199

Details

Abstract

We herein report two cases of patients with thyroid storm with a delayed diagnosis due to psychosis. The patients were a 63-year-old woman with bipolar II disorder and a 37-year-old man with major depressive disorder. The psychoses in both patients were well controlled with medication. Although they both showed symptoms of thyrotoxicosis, the symptoms were ignored, presumably because the psychological manifestations of worsening of psychosis and thyroid storm are similar. When the mental or physical state of patients with psychosis changes, thyroid hormone levels should be measured for early treatment.

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