Psychotic Symptoms in a Patient with Hashimoto’s Thyroditis
K. Kontoangelos *
1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece and University Mental Health Research Institute, Athens, Greece.
M. Economou
1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece and University Mental Health Research Institute, Athens, Greece.
A. Kandaraki
University Mental Health Research Institute, Athens, Greece.
V. Mylona
2nd Department of Internal Medicine, Sismanoglio Hospital, Athens, Greece.
I. Makrygiannis
2nd Department of Internal Medicine, Sismanoglio Hospital, Athens, Greece.
G. N. Papadimitriou
1st Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece.
*Author to whom correspondence should be addressed.
Abstract
Objective: Psychopathological symptoms, depression, apathy, memory and sleep disorders, have been reported in patients with Hashimoto’s thyroiditis, but psychotic symptoms without psychiatric background are extremely rare.
Method: A 74 year male patient without previous psychiatric history was presented with acute psychotic symptoms to the emergency department and was hospitalized for three days.
Results: The laboratory profile showed the presence of high titer of serum thyroid antibodies (ANTI-TG>4000IU/ml, n.r.=0.0-115.0 IU/ml), high titer (corrected) of serum Anti-thyroid peroxidase antibodies (Α-TPO: 386.7 IU/ml, n.r.:0.34 IU/ml) and high Thyroidstimulating hormone TSH: 45.6μΙU/ml,n.r.:2.03-4.01μIU/ml, T4(Thyroxine =6.98μg/dL, (n.r.:5.10-14.10μg/dL), T3triiodothyronine=0.84ng/mL (n.r.:0.80-2.00ng/mL). The diagnosis of primary hypothyroidism was made due to Hashimoto’s thyroiditis.
Conclusion: Since psychiatric symptoms may be one of the earliest manifestations of hypothyroidism, they are often misdiagnosed as functional psychiatric disorders. This confusion can lead to delayed treatment.
Keywords: Psychosis, hashimoto’s thyroditis