Clinical Case Database / Category: Clinical Care

Thyrotoxicosis factitia

Publication details

Mohan Singh, MRCS, Martin Sintler, MBChB, MMedSci, FRCS
Foundation Years Journal, volume 6, issue 4, p.40 (123Doc Education, London, April 2012)

Abstract

A 34 year old lady who had been treated for thyrotoxicosis for the past 18 months was admitted to hospital by an endocrinologist. After discharge he found her thyrotoxicosis frequently refractory to medical treatment. He recruited assistance from the patient’s general practitioner (GP) to ensure she was compliant with her medications and also a surgeon as it seemed likely that a thyroidectomy would be the only effective solution. After some months endeavoring to make her biochemically euthyroid, he eventually succeeded and she underwent a total thyroidectomy. However, the histology from the excised gland and the post-operative picture did not augur well with aggressive thyrotoxicosis. This case based discussion pontificates a clinical scenario that is inherently difficult to diagnose and may lead to inappropriate treatment.

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Authors

Mohan Singh, MRCS (Corresponding author)

Specialist Registrar in General Surgery
Sandwell General Hospital
Lyndon
West Bromwich
Birmingham
B71 4HJ

Martin Sintler, MBChB, MMedSci, FRCS (Corresponding author)

Consultant General and Breast Surgeon
Sandwell General Hospital
Lyndon
West Bromwich
Birmingham
B71 4HJ

References

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Figure 1
http://www.thyroidtest.org/thyroidprofiletest.aspx
Figure 2
http://asbaquez.blogspot.com/2011/06/graves-disease-understanding-and.html
Figure 3
http://www.endocrinesurgery.net.au/thyroidanatomy/
Figure 4
http://www.cedars-sinai.edu/Patients/Programs-and-Services/Head-and-Neck-Cancer-Center/Treatment/Parathyroidectomy.aspx
Figure 5
http://www.endocrinesurgery.net.au/parathyroid-anatomy/
Figure 6
http://jmichek.blogspot.com/2010/09/baron-von-munchausen.html

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