Parikh Nimesh, Sharma Prateek, Parmar Chirag
Department of psychiatry, V S Hospital, Ahmedabad, Gujarat, India.
Indian J Psychol Med. 2014 Jan;36(1):80-1. doi: 10.4103/0253-7176.127260.
Myxedema madness is a very rare but established entity. A psychotic patient having hypothyroid features should always be evaluated regarding same. A 30-year-old female without known significant past medical history had, for the past one and half year, continuous persecutory and referential delusions; second and third person auditory hallucinations, facial puffiness and Brief Psychiatric Rating Scale (BPRS) score of 41 on admission. Her thyroid profile was: Thyroid stimulating hormone - 63.71 mIU/L, Free tri iodo threonine (FT3) - 2.1 pg/ml, free tetra iodo thyronine (FT4) - 0.6 ng/ml with normal ultrasound-thyroid. Patient was started on thyroxin 100 μg with a low dose risperidone 2 mg. Risperidone was withdrawn over a week and the patient was discharged on thyroxin alone with BPRS score of 8 and absence of delusions and hallucinations.
黏液水肿性癫狂是一种非常罕见但已被确认的病症。对于有甲状腺功能减退特征的精神病患者，应始终对其进行相关评估。一名30岁女性，既往无重大病史，在过去一年半的时间里，持续存在被害妄想和关系妄想；有第二和第三人称幻听、面部浮肿，入院时简明精神病评定量表（BPRS）评分为41分。她的甲状腺功能指标如下：促甲状腺激素 - 63.71 mIU/L，游离三碘甲状腺原氨酸（FT3） - 2.1 pg/ml，游离甲状腺素（FT4） - 0.6 ng/ml，甲状腺超声检查正常。患者开始服用100μg甲状腺素，并联合低剂量2mg利培酮。一周后停用利培酮，患者仅服用甲状腺素出院，此时BPRS评分为8分，妄想和幻觉消失。
