Unusual Presentation of Primary Hypothyroidism
Sandeep Kr. Agarwal *
Department of Endocrinology, Gauhati Medical College and Hospital, Guwahati, India.
Dipti Sarma
Department of Endocrinology, Gauhati Medical College and Hospital, Guwahati, India.
Uma Kaimal Saikia
Department of Endocrinology, Gauhati Medical College and Hospital, Guwahati, India.
Bipul Choudhury
Department of Endocrinology, Gauhati Medical College and Hospital, Guwahati, India.
*Author to whom correspondence should be addressed.
Abstract
Primary hypothyroidism may present with myriad of unusual presentation apart from typically described signs and symptoms. We report an unusual case of primary hypothyroidism clinically presenting as acute psychosis and radiologically mimicking as pituitary macroadenoma. A 19-year-old female presented with h/o abnormal behaviour in the form of auditory hallucination, fearfulness, loss of memory and inability to recognise family members six months back. She also gave h/o multiple joint pain, easy fatigability, facial puffiness, somnolence, progressive weight gain, constipation and cold intolerance for similar duration. MRI brain revealed enlarged pituitary, while the thyroid function analysis pointed towards primary hypothyroidism. Patient improved with LT4.
Keywords: Hypothyroidism, psychosis, pituitary hyperplasia.