A case of masked toxic adenoma in a patient with non-thyroidal illness.

Abstract:

BACKGROUND:Non-thyroidal illness (NTI) refers to changes in thyroid hormone levels in critically ill patients in the absence of primary hypothalamic-pituitary-thyroid dysfunction, and these abnormalities usually resolve after clinical recovery. However, NTI can be accompanied by primary thyroid dysfunction. We report herein a case of a woman with NTI accompanied by primary hyperthyroidism. CASE PRESENTATION:A 52-year-old female was admitted to the intensive care unit with heart failure and atrial fibrillation. She had a longstanding thyroid nodule, and a thyroid function test revealed low levels of triiodothyronine and free thyroxine as well as undetectable thyroid stimulating hormone (TSH). She was diagnosed with NTI, and her TSH level began to recover but not completely at discharge. The thyroid function test was repeated after 42 months to reveal primary hyperthyroidism, and a thyroid scan confirmed a toxic nodule. CONCLUSION:This case suggests that although NTI was diagnosed, primary hyperthyroidism should be considered as another possible diagnosis if TSH is undetectable. Thyroid function tests should be repeated after clinical recovery from acute illness.

journal_name

BMC Endocr Disord

journal_title

BMC endocrine disorders

authors

Cho EA,Yoon JH,Kim HK,Kang HC

doi

10.1186/1472-6823-14-1

subject

Has Abstract

pub_date

2014-01-02 00:00:00

pages

1

issn

1472-6823

pii

1472-6823-14-1

journal_volume

14

pub_type

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