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First Episode Psychosis and Pituitary Hyperplasia in a Patient With Untreated Hashimoto’s Thyroiditis: A Case Report

Authors :
Celeste Lipkes
Shanzay Haider
Ali Rashid
Gustavo A. Angarita
Sarah Riley
Source :
Frontiers in Psychiatry, Vol 13 (2022)
Publication Year :
2022
Publisher :
Frontiers Media S.A., 2022.

Abstract

This case report describes a woman with no psychiatric history and previously diagnosed Hashimoto’s thyroiditis who presented to the psychiatric emergency department with a first episode of psychosis. The initial workup for organic causes of psychosis revealed an astronomically high thyroid stimulating hormone (TSH) (> 1,000 μIU/mL) out of proportion to the patient’s minimal physical symptoms of hypothyroidism. Additionally the patient’s head imaging showed an enlarged pituitary, a rare, but reversible, presentation of chronically untreated primary hypothyroidism. The patient was transferred to a medical unit to receive IV thyroid hormone replacement as well as an adjunctive antipsychotic to assist with remission of her distressing auditory hallucinations and persecutory delusions. This case highlights the importance of a thorough medical workup for causes of new onset psychosis and the need for further consensus in the literature regarding choice of antipsychotic and duration of treatment for psychosis secondary to hypothyroidism.

Details

Language :
English
ISSN :
16640640
Volume :
13
Database :
Directory of Open Access Journals
Journal :
Frontiers in Psychiatry
Publication Type :
Academic Journal
Accession number :
edsdoj.0298071ab3134716a4fee48e9a52781c
Document Type :
article
Full Text :
https://doi.org/10.3389/fpsyt.2022.863898