Past Issues

Acute Psychosis in a Patient with Hashimoto's Thyroiditis

Zon-Yi Tsai, M.D.1 Hua-An Shuai, M.D.1 Chia-Chun Wang, M.D.1 Guang-Yang Tsai, M.D.2 

Objectives:We report a patient with Hashimoto's thyroiditis (HT) who presented with hyperthyroidism and psychotic symptoms. Case report:A 43-yearold male patient had suffered from palpitations of the heart for one year. One week before admission, he had a sudden onset of delusion and hallucinations. Three days after admission, he developed delirium. The results of the laboratory examinations showed HT in hyperthyroid state with high level of anti-thyroid antibodies. After having received anti-thyroid drugs and antipsychotic drugs, he was observed to have complete recovery of the physical and psychotic symptoms. Based on the progressive nature of the course of this patient’s disease and the response to treatment, we diagnosed the patient to have psychotic disorder due to HT. He had been well in the follow-up. Conclusion:This case report suggests that screening of serum anti-thyroid antibodies for any patient with atypical psychosis with thyroid dysfunction is needed, and that Hashimoto's disease should be considered in any patient with atypical psychosis, as prompt recognition and management can lead to an excellent treatment outcome.
Key Word psychosis, Hashimoto's thyroiditis, hyperthyroidism, delirium
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