da Silva Joaquim Alves, Almeida Jaime Traça, Corrêa Bernardo Barahona, Narigão Miguel, Xavier Miguel
Faculty of Medical Sciences, Mental health, Department of Mental Health - UNL Calçada da Tapada, 155, Lisbon 1300, Portugal.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.08.2008.0676. Epub 2009 Mar 17.
Psychotic syndromes in the context of hyperthyroidism are seldom mentioned in medical textbooks and only a few cases have been published. Typically, such cases present as an affective psychosis. Schizophrenia-like psychosis is a rare occurrence in hyperthyroidism and the link between these two conditions is still poorly understood.We report the case of a female patient with a known history of chronic lymphocytic thyroiditis. The patient presented to our emergency department with an acute schizophrenia-like psychosis. Elevated levels of T4 and free T4 were found. These resulted from the patient's voluntary intake of excess levothyroxine as an attempt to lose weight (thyrotoxicosis factitia). Normalisation of thyroid hormone levels and antipsychotic treatment led to prompt remission of the psychosis. Even though the patient stopped the antipsychotics, she remained free of symptoms during the follow-up. Similar cases are briefly reviewed and some of the data from basic research is also considered.
甲状腺功能亢进症相关的精神病综合征在医学教科书中很少被提及，仅有少数病例被报道。通常，此类病例表现为情感性精神病。精神分裂症样精神病在甲状腺功能亢进症中较为罕见，这两种病症之间的联系仍未被充分理解。我们报告了一例有慢性淋巴细胞性甲状腺炎病史的女性患者。该患者因急性精神分裂症样精神病就诊于我们的急诊科。检测发现T4和游离T4水平升高。这是由于患者为减肥而自行过量服用左甲状腺素所致（人为性甲状腺毒症）。甲状腺激素水平恢复正常并进行抗精神病治疗后，精神病症状迅速缓解。尽管患者停用了抗精神病药物，但在随访期间仍无症状。本文简要回顾了类似病例，并考虑了一些基础研究的数据。
