Omri Moujib, Ferhi Mohamed, Lentz Nina, Oliveira Galvao Marizia, Hamm Oliver
Psychiatry and Psychotherapy Department, Klinikum Mutterhaus der Borromäerinnen, Trier, DEU.
Psychiatry Department, Ibn El Jazzar University Hospital, Kairouan, TUN.
Cureus. 2024 Mar 30;16(3):e57259. doi: 10.7759/cureus.57259. eCollection 2024 Mar.
Myxedema psychosis (MP), a rare psychiatric manifestation of hypothyroidism, presents significant diagnostic and therapeutic challenges. This case report details the presentation, diagnosis, and successful management of a 60-year-old woman with MP, who was initially admitted to the psychiatric department for new-onset psychosis following the cessation of hormone replacement therapy after a subtotal thyroidectomy performed 20 years prior. Despite the rarity of psychosis as an initial presentation of hypothyroidism, this case underscores the critical importance of considering endocrine disorders in the differential diagnosis of unexplained psychotic symptoms. The clinical findings included a polymorphic delusional system and auditory hallucinations, without significant abnormalities on magnetic resonance imaging. Elevated thyroid-stimulating hormone (TSH) levels confirmed hypothyroidism, leading to the diagnosis of MP. Treatment with l-thyroxine resulted in complete resolution of symptoms in three weeks, highlighting the efficacy of hormone replacement therapy. This case contributes to the limited literature on MP and echoes the need for awareness among clinicians to ensure timely and accurate diagnosis and treatment.
黏液性水肿性精神病（MP）是甲状腺功能减退症的一种罕见精神表现，带来了重大的诊断和治疗挑战。本病例报告详细介绍了一名60岁患有MP的女性的临床表现、诊断及成功治疗过程。该女性20年前接受了甲状腺次全切除术后停止激素替代治疗，最初因新发精神病入住精神科。尽管精神病作为甲状腺功能减退症的首发表现较为罕见，但该病例强调了在不明原因的精神病症状鉴别诊断中考虑内分泌疾病的至关重要性。临床发现包括多形性妄想系统和幻听，磁共振成像未发现明显异常。促甲状腺激素（TSH）水平升高证实为甲状腺功能减退症，从而诊断为MP。左甲状腺素治疗在三周内使症状完全缓解，突出了激素替代治疗的有效性。本病例丰富了关于MP的有限文献，并再次强调临床医生需要提高认识，以确保及时准确的诊断和治疗。
