Chakraborty Partha Pratim, Goswami Soumik, Bhattacharjee Rana, Chowdhury Subhankar
Endocrinology and Metabolism, Medical College, Kolkata, West Bengal, India.
Endocrinology, Nil Ratan Sircar Medical College, Kolkata, West Bengal, India.
BMJ Case Rep. 2019 Apr 29;12(4):e226087. doi: 10.1136/bcr-2018-226087.
Thyrotoxicosis factitia, a disorder frequently seen in young or middle-aged women with psychological disorders, most commonly results from surreptitious ingestion of excess thyroid hormones. In most patients, diagnosis is relatively straightforward and depends on the demonstration of biochemical thyrotoxicosis, suppressed endogenous thyroid function and absence of clinical features of underlying thyroid disease. However, at times, confounding factors can make the diagnosis particularly challenging and necessitate the investigating physician to don the detective's cap to get to the root of the problem. We discuss a patient whose diagnosis was reached with ingenuity after considerable effort from four endocrinologists having a total experience of 37 years in their field.
人为性甲状腺毒症常见于患有心理障碍的中青年女性，多由偷偷过量摄入甲状腺激素所致。多数患者的诊断相对简单，依据生化性甲状腺毒症、内源性甲状腺功能受抑制以及无潜在甲状腺疾病的临床特征来确诊。然而，有时一些混杂因素会使诊断极具挑战性，这就需要负责调查的医生像侦探一样去探寻问题的根源。我们将讨论这样一位患者，在四位内分泌科医生总计37年的专业经验下，经过一番努力才巧妙地做出诊断。
