Deliberate self-harm in a patient with hyperthyroidism with acute psychosis
A woman in her 30s with underlying Graves' disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels...
Saved in:
Main Authors: | , |
---|---|
Format: | Article |
Published: |
BMJ Publishing Group
2021
|
Subjects: | |
Online Access: | http://eprints.um.edu.my/34907/ |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
my.um.eprints.34907 |
---|---|
record_format |
eprints |
spelling |
my.um.eprints.349072022-05-26T03:49:56Z http://eprints.um.edu.my/34907/ Deliberate self-harm in a patient with hyperthyroidism with acute psychosis Wong, Haw Huo Pang, Nicholas Tze Ping R Medicine (General) A woman in her 30s with underlying Graves' disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient's own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible. BMJ Publishing Group 2021-10 Article PeerReviewed Wong, Haw Huo and Pang, Nicholas Tze Ping (2021) Deliberate self-harm in a patient with hyperthyroidism with acute psychosis. BMJ Case Reports, 14 (10). ISSN 1757-790X, DOI https://doi.org/10.1136/bcr-2021-242333 <https://doi.org/10.1136/bcr-2021-242333>. 10.1136/bcr-2021-242333 |
institution |
Universiti Malaya |
building |
UM Library |
collection |
Institutional Repository |
continent |
Asia |
country |
Malaysia |
content_provider |
Universiti Malaya |
content_source |
UM Research Repository |
url_provider |
http://eprints.um.edu.my/ |
topic |
R Medicine (General) |
spellingShingle |
R Medicine (General) Wong, Haw Huo Pang, Nicholas Tze Ping Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
description |
A woman in her 30s with underlying Graves' disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient's own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible. |
format |
Article |
author |
Wong, Haw Huo Pang, Nicholas Tze Ping |
author_facet |
Wong, Haw Huo Pang, Nicholas Tze Ping |
author_sort |
Wong, Haw Huo |
title |
Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
title_short |
Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
title_full |
Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
title_fullStr |
Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
title_full_unstemmed |
Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
title_sort |
deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
publisher |
BMJ Publishing Group |
publishDate |
2021 |
url |
http://eprints.um.edu.my/34907/ |
_version_ |
1735409632823738368 |
score |
13.160551 |