scholarly journals Myxedema Psychosis after Levothyroxine Withdrawal in Radioactive Iodine Treatment of Differentiated Thyroid Cancer: A Case Report

2021 ◽  
pp. 1596-1600
Author(s):  
Nutnicha Pattaravimonporn ◽  
Thanat Chaikijurajai ◽  
Wichana Chamroonrat ◽  
Chutintorn Sriphrapradang
Keyword(s):  
Radioactive Iodine ◽  
Auditory Hallucination ◽  
Neuropsychiatric Symptoms ◽  
Hormone Replacement ◽  
Signs And Symptoms ◽  
Psychotic Symptoms ◽  
Acute Psychosis ◽  
Paranoid Delusion ◽  
Thyroid Hormone Replacement Therapy ◽  
Iodine Treatment

Neuropsychiatric symptoms, especially acute psychosis (often referred to as myxedema madness or psychosis), are rare but possible clinical presentations of patients with hypothyroidism. A 42-year-old woman with papillary thyroid carcinoma and recent total thyroidectomy had developed flat affect, paranoid delusion, and visual and auditory hallucination during inpatient admission for elective radioactive iodine treatment. On admission, her history and physical exam did not reveal symptoms and signs of significant hypothyroidism. Other medical causes of acute psychosis were excluded, and the patient was immediately treated with thyroid hormone replacement therapy. Subsequently, her thyroid function normalized, and her psychotic symptoms gradually improved. Although there is a lack of classic signs and symptoms of hypothyroidism, myxedema madness should be recognized as one of the potentially treatable causes of acute psychosis.

Psychotic disorder after radioactive iodine treatment in a 42-year-old woman thyroidectomized for papillary thyroid carcinoma: case report

2011 ◽  
Vol 26 (S2) ◽  
pp. 1733-1733 ◽  
Author(s):  
M. Manea ◽  
V. Rusanu ◽  
B.E. Patrichi ◽  
R.M. Stoean ◽  
M.M. Cristina ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Papillary Thyroid Carcinoma ◽  
Replacement Therapy ◽  
Psychotic Disorder ◽  
Radioactive Iodine ◽  
Hormone Replacement ◽  
Papillary Thyroid ◽  
Thyroid Hormone Replacement ◽  
Thyroid Hormone Replacement Therapy ◽  
Iodine Treatment

IntroductionReports in the medical literature describe several cases of acute onset psychosis as a result of hypothyroidism, and a small number related to radioactive iodine treatment (RAIT). The effectiveness of RAIT in the therapy of differentiated thyroid cancer depends on a sufficient TSH level elevation obtained by discontinuing thyroid hormone replacement therapy.ObjectivesDescribing a case of new-onset psychotic disorder in a 42-year-old woman following a RAIT session, one year after total thyroidectomy for papillary thyroid carcinoma developed on multinodular goiter.AimsIdentifying a relation between the psychosis onset and the therapeutic protocol the patient underwent for the thyroid disease treatment.MethodsWe present the case of a patient with a medical history of thyroid disease, secondary posttraumatic epilepsy and minor thalassemia; the clinical and paraclinical evaluations; the psychiatric presentation, treatment and evolution.ResultsThe overt psychotic symptomatology developed in this case a few days after RAIT and led to an emergency psychiatric hospitalization, the laboratory findings showed a TSH value of 75 microunits/ml. The psychotic episode remitted after a month of antypsichotic medication and levothyroxinum replacement therapy. The patient has been receiving psychotropic medication for a year, during which she was readmitted for a depressive episode (6 months after first discharge).ConclusionsThe patient's psychotic disorder developed after a period of thyroid hormone replacement therapy discontinuation and consecutive to the RAIT session, which indicates that in susceptible individuals there is a risk for psychosis with this therapeutical strategy.

scholarly journals Delirious Mania Associated with Autoimmune Gastrothyroidal Syndrome of a Mid-Life Female: The Role of Hashimoto Encephalopathy and a 3-Year Follow-Up including Serum Autoantibody Levels

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Udo Bonnet ◽  
Claudia Selle ◽  
Ralf Kuhlmann
Keyword(s):  
Autoimmune Thyroiditis ◽  
Neuropsychiatric Symptoms ◽  
Hormone Replacement ◽  
Potential Contribution ◽  
Glucocorticoid Treatment ◽  
Serum Autoantibody ◽  
Hashimoto Encephalopathy ◽  
Autoimmune Polyendocrine Syndrome ◽  
Thyroid Hormone Replacement Therapy

We report the case study of a 57-year-old Caucasian female with steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT), commonly termed Hashimoto encephalopathy (HE). This presentation includes one of the longest lasting follow-up studies of HE considering the neuropsychiatric symptoms (here delirium, mania, and EEG-slowing) and their relation to serum autoantibody levels. Antithyroid-peroxidase autoantibodies, the hallmark of autoimmune thyroiditis, were found in the serum and also in the cerebrospinal fluid. Diagnostic analyses found no evidence of limbic encephalopathies characterized by serum antibodies against intracellular, synaptic, or further cell surface antigenic targets, neoplasm, and connective tissue or vasculitis diseases. A potential contribution of bipolar disorder and metabolic encephalopathies due to severe hypothyroidism, glucocorticoid treatment, accelerated thyroid hormone replacement therapy, or vitamin B deficiency is critically discussed. Another special feature of this case report is the linkage of HE to an autoimmune polyendocrine syndrome (type 3B) affecting the gastroduodenum in addition to the thyroid gland.

scholarly journals Dissociative Amnesia with Dissociative Fugue and Psychosis: a Case Report from a 25-Year-Old Ethiopian Woman

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Liyew Agenagnew ◽  
Elias Tesfaye ◽  
Selamawit Alemayehu ◽  
Mathewos Masane ◽  
Tilahun Bete ◽  
...  
Keyword(s):  
Case Report ◽  
Psychotic Disorders ◽  
Traumatic Event ◽  
Auditory Hallucination ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Therapeutic Interventions ◽  
Psychotic Symptoms ◽  
Dissociative Amnesia ◽  
Scientific World

Introduction. The case after exposure to intense traumatic events manifests signs and symptoms of dissociative amnesia with a dissociative fugue and schizophrenia. The psychotic symptoms we found, in this case, were very complicated and mimicking primary psychotic disorders. Therefore, this might be a good forum for the scientific world to learn from this case report, how psychotic disorders coexist with dissociative disorders, since the literatures in this area are too rare. Main Symptoms and/or Important Clinical Findings. This case report focuses on the case of dissociative amnesia with dissociative fugue and psychosis in a 25-year-old Ethiopian female who lost her husband and three children at the same time during the nearby ethnic conflict. Associated with amnesia, she lost entire autobiographical information, and she also had psychotic symptoms like delusions and auditory hallucination which is related to the traumatic event she faced. The Main Diagnoses, Therapeutic Interventions, and Outcomes. The diagnosis of dissociative amnesia with a dissociative fugue comorbid with schizophrenia was made, and both pharmacological and psychological interventions were given to the patient. After the intervention, the patient had a slight improvement regarding psychotic symptoms but her memory problem was not restored. Conclusions. The observation in this case report brings to the fore that individuals with dissociative amnesia with dissociative fugue can have psychotic symptoms, and it takes a longer time to recover from memory disturbances.

scholarly journals Acute psychosis due to brucellosis in a rural Iran: a report of two cases

2013 ◽  
Vol 2 (1) ◽  
pp. 29-31 ◽  
Author(s):  
R Bidaki ◽  
SM Yassini ◽  
MT Maymand ◽  
M Mashayekhi ◽  
S Yassini
Keyword(s):  
Case Report ◽  
Behavioral Disorders ◽  
Auditory Hallucination ◽  
Rare Condition ◽  
Zoonotic Disease ◽  
Psychotic Symptoms ◽  
Psychotic Depression ◽  
Acute Psychosis ◽  
Systemic Involvement ◽  
Endemic Areas

Introduction: Brucellosis is a zoonotic disease that causes multi systemic involvement. Neurobrucellosis occurs in less than 5% of patients. Psychosis as a presentation of neuro-brucellosis is a rare condition. Case Report: We report a woman that was referred because of psychotic depression following brucellosis. Also we present a 66-year-old man that was admitted because of acute psychotic symptoms. He had behavioral disorders, visual and auditory hallucination, restlessness, impulsivity, incoherency and episodic crying. Neurobrucellosis was confirmed. Conclusion: In patients with atypical psychosis in endemic areas, physicians should consider the portability of brucellosis. DOI: http://doi.dx.org/10.3126/ijim.v2i1.8007 Int J Infect Microbiol 2013;2(1):29-31

scholarly journals Acute psychosis caused by hypothyroidism following radioactive iodine treatment of Graves’ disease

2013 ◽  
Vol 4 (4) ◽  
pp. 1-4 ◽  
Author(s):  
Catherine Hyams ◽  
Pavan Joshi ◽  
Paul Foster ◽  
Jonathan Katz
Keyword(s):  
Radioactive Iodine ◽  
Graves Disease ◽  
Acute Psychosis ◽  
Iodine Treatment

Uncertainty in the management of thyroid cancer.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 238-238
Author(s):  
Megan Haymart ◽  
Mousumi Banerjee ◽  
Di Yang ◽  
Andrew Stewart ◽  
James Sisson ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Hormone ◽  
Radioactive Iodine ◽  
Hormone Replacement ◽  
Thyroid Hormone Replacement ◽  
Cancer Management ◽  
Post Surgery ◽  
Iodine Treatment

238 Background: Little is known about treatment practices in thyroid cancer, a cancer that is increasing in incidence. We sought to identify aspects of thyroid cancer management that have the greatest variation and thereby uncertainty in management. Methods: We surveyed 944 physicians involved in thyroid cancer care from 251 hospitals affiliated with the U.S. National Cancer Database. Using vignettes and additional survey items, physicians were asked questions in the following four domains: thyroid surgery, radioactive iodine use, thyroid hormone replacement post-surgery, and long-term thyroid cancer management. To identify aspects of thyroid cancer management with the greatest uncertainty, we calculated the ratio of observed variation to hypothetical maximum variation under the assumed distribution of the response. Ratios closer to 1 indicate greater uncertainty. Results: There is large uncertainty in multiple aspects of thyroid cancer management, including the role of central lymph node dissections, the role of pretreatment scans before radioactive iodine treatment, and all aspects of long-term thyroid cancer management, including applications of ultrasound and radioactive iodine scans. For the management of small thyroid cancers, uncertainty exist in all domains, including optimal extent of surgery and the role of both radioactive iodine treatment and suppressive doses of thyroid hormone replacement. Conclusions: We identified areas of uncertainty in thyroid cancer management. Since both a lack of data and a lack of acceptance of the existing data may be contributing to the variation demonstrated, to improve the management of thyroid cancer there is a need for more research and more research dissemination.

scholarly journals Acute Psychosis as Major Clinical Presentation of Legionnaires’ Disease

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Ricardo Coentre ◽  
Amílcar Silva-dos-Santos ◽  
Miguel Cotrim Talina
Keyword(s):  
Legionella Pneumophila ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Lower Lobe ◽  
Epidemiological Data ◽  
Clinical History ◽  
Psychotic Symptoms ◽  
Acute Psychosis ◽  
Legionnaires Disease ◽  
The Right

We report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires’ disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum. Epidemiological data suggestedLegionella pneumophilaas possible cause of the clinical picture that was confirmed by urinary antigen detection and polymerase chain reaction of the sputum. She was treated with levofloxacin 750 mg/day for 10 days with complete remission of pulmonary and psychiatric symptoms. She has not had further psychotic symptoms.

Neuropsychiatric Symptoms and Antipsychotic Therapy in the Elderly Patients with Dementia

Psychiatry ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 6-15
Author(s):  
I. V. Kolykhalov
Keyword(s):  
Neuropsychiatric Symptoms ◽  
The Elderly ◽  
Psychotic Symptoms ◽  
Mixed Dementia ◽  
Short Term ◽  
Antipsychotic Therapy ◽  
Dementia Patients ◽  
Frequency Of Use ◽  
Number Of Patients ◽  
High Incidence

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.

scholarly journals 405 - Music Therapy in the management of dementia

2020 ◽  
Vol 32 (S1) ◽  
pp. 121-121
Author(s):  
Catarina Pedro ◽  
Beatriz Jorge ◽  
Mariana Duarte
Keyword(s):  
Cognitive Function ◽  
Music Therapy ◽  
Behavioral Problems ◽  
Positive Impact ◽  
Current Knowledge ◽  
Neuropsychiatric Symptoms ◽  
World Health ◽  
Psychotic Symptoms ◽  
The World ◽  
Health Organization

Introduction:Dementia has become a worldwide concern. According to the World Health Organization, there are 50 million individuals suffering from dementia across the world and approximately 20 million new cases are diagnosed each year. The efficacy of medications in controlling agitation and psychotic symptoms is modest and may cause serious adverse effects, outlining the urge for new treatment methods for patients with dementia. Music therapy (MT) is a nonpharmacologic strategy that is used in patients with early-to-late stages of dementia with promising results.Objectives:The aim of this presentation is to evaluate the benefits of music therapy in cognitive functioning and neuropsychiatric symptoms in patients diagnosed with dementia. We also summarize the current knowledge about this topic.Methods:A non-systematic review of the literature was performed on PubMed, PsycINFO and Web of science using selected keywords.Results:MT sustains its benefit because musical memory regions in the brain are relatively spared compared to cognitive function. “Musical memories” can, thus, be stored longer than non-musical memories, allowing to recall associated life events and emotions. Systematic reviews suggest that MT seem to have a positive effect on symptoms such as depression, anxiety and behavioral problems while the findings concerning agitation/aggression are inconsistent. No large differences were found between studies using live or recorded music although the latter reported more of a consistently positive impact on behavioral and psychological outcomes. The studies using live music, however, reported specific benefits to relationships and interactions.Conclusions:The majority of the studies have methodological limitations, making it difficult to offer firm conclusions. Despite this, there were positive results on aspects of quality of life, cognitive function, behavioral, psychological, physiological and communication outcomes.

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