Shlykov Maksim A, Rath Swapnil, Badger Alison, Winder Gerald Scott
University of Michigan Medical School, Ann Arbor, Michigan, USA.
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.
BMJ Case Rep. 2016 Sep 9;2016:bcr2016215957. doi: 10.1136/bcr-2016-215957.
We present the case of an elderly woman with hypothyroidism and no psychiatric history who presented with new onset of psychosis, paranoia, catatonic features and Capgras syndrome (CS). This case illustrates the spectrum of neuropsychiatric symptoms that may accompany hypothyroidism and the importance of considering thyroid dysfunction as a primary contributor to severe psychiatric symptoms, especially in previously stable patients. We demonstrate the effectiveness of combination levothyroxine and olanzapine, with its favourable cardiac profile, in the treatment of myxoedema madness. Antipsychotics can be weaned once psychiatric symptoms resolve and hormone levels are stabilised.
我们报告了一例老年女性患者，该患者患有甲状腺功能减退症且无精神病史，出现了新发的精神病性症状、偏执、紧张症特征及卡普格拉综合征（CS）。该病例说明了甲状腺功能减退症可能伴随的一系列神经精神症状，以及将甲状腺功能障碍视为严重精神症状主要原因的重要性，尤其是在既往病情稳定的患者中。我们证明了左甲状腺素和奥氮平联合使用在治疗黏液性水肿性疯狂方面的有效性，其对心脏的影响较好。一旦精神症状缓解且激素水平稳定，抗精神病药物可以逐渐减量。
