Deliberate self-harm in a patient with hyperthyroidism with acute psychosis
A woman in her 30s with underlying Graves’ disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and...
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| Format: | Article |
| Language: | English English |
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S. Karger AG
2021
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| Online Access: | https://eprints.ums.edu.my/id/eprint/32776/1/Deliberate%20self-harm%20in%20a%20patient%20with%20hyperthyroidism%20with%20acute%20psychosis.ABSTRACT.pdf https://eprints.ums.edu.my/id/eprint/32776/2/Deliberate%20self-harm%20in%20a%20patient%20with%20hyperthyroidism%20with%20acute%20psychosis.pdf |
| _version_ | 1796911280201662464 |
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| author | Haw Huo Wong Pang, Nicholas Tze Ping |
| author_facet | Haw Huo Wong Pang, Nicholas Tze Ping |
| author_sort | Haw Huo Wong |
| collection | UMS |
| description | A woman in her 30s with underlying Graves’ disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient’s own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible. |
| first_indexed | 2024-03-06T03:16:31Z |
| format | Article |
| id | ums.eprints-32776 |
| institution | Universiti Malaysia Sabah |
| language | English English |
| last_indexed | 2024-03-06T03:16:31Z |
| publishDate | 2021 |
| publisher | S. Karger AG |
| record_format | dspace |
| spelling | ums.eprints-327762022-06-15T02:36:12Z https://eprints.ums.edu.my/id/eprint/32776/ Deliberate self-harm in a patient with hyperthyroidism with acute psychosis Haw Huo Wong Pang, Nicholas Tze Ping RC512-528 Psychoses A woman in her 30s with underlying Graves’ disease, who recently completed radioactive iodine treatment, presented with 2 weeks of acutely altered behaviour associated with auditory hallucinations and religious preoccupations. Laboratory investigation demonstrated elevated free thyroxine levels and suppressed thyroid-stimulating hormone levels. Additionally, there was a presence of antithyroid peroxidase antibodies consistent with autoimmune thyroid disease. She responded to antipsychotics and achieved biochemical euthyroidism. Subsequently, antipsychotic was tapered off during outpatient follow-up at the patient’s own request, with supplement thyroxine continuing. After 1 week, acute hallucinations and religious preoccupations re-emerged, driving her to inflict self-injuries by swallowing coins and nails and banging her head against the wall, sustaining laceration wounds. Furthermore, she hammered a roofing nail into the external genitalia, embedded in the symphysis pubis. After supplemental thyroxine was stopped and olanzapine was started, she achieved biochemical euthyroid followed by remission of psychosis within 1 week. This case illustrates the importance of elucidating organic causes of psychosis as they are easily and swiftly reversible. S. Karger AG 2021-10-14 Article PeerReviewed text en https://eprints.ums.edu.my/id/eprint/32776/1/Deliberate%20self-harm%20in%20a%20patient%20with%20hyperthyroidism%20with%20acute%20psychosis.ABSTRACT.pdf text en https://eprints.ums.edu.my/id/eprint/32776/2/Deliberate%20self-harm%20in%20a%20patient%20with%20hyperthyroidism%20with%20acute%20psychosis.pdf Haw Huo Wong and Pang, Nicholas Tze Ping (2021) Deliberate self-harm in a patient with hyperthyroidism with acute psychosis. Case Report in Neurology, 14. pp. 1-5. ISSN 1662-680X https://casereports.bmj.com/content/14/10/e242333 http://dx.doi.org/10.1136/bcr-2021-242333 http://dx.doi.org/10.1136/bcr-2021-242333 |
| spellingShingle | RC512-528 Psychoses Haw Huo Wong Pang, Nicholas Tze Ping Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
| title | Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
| title_full | Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
| title_fullStr | Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
| title_full_unstemmed | Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
| title_short | Deliberate self-harm in a patient with hyperthyroidism with acute psychosis |
| title_sort | deliberate self harm in a patient with hyperthyroidism with acute psychosis |
| topic | RC512-528 Psychoses |
| url | https://eprints.ums.edu.my/id/eprint/32776/1/Deliberate%20self-harm%20in%20a%20patient%20with%20hyperthyroidism%20with%20acute%20psychosis.ABSTRACT.pdf https://eprints.ums.edu.my/id/eprint/32776/2/Deliberate%20self-harm%20in%20a%20patient%20with%20hyperthyroidism%20with%20acute%20psychosis.pdf |
| work_keys_str_mv | AT hawhuowong deliberateselfharminapatientwithhyperthyroidismwithacutepsychosis AT pangnicholastzeping deliberateselfharminapatientwithhyperthyroidismwithacutepsychosis |