Endocrine Abstracts

Background: Psychiatric symptoms have been reported quite frequently in thyroid disease. Dementia associated with hyperthyroidism is less well documented.

The case: We present the case of a 62 years old woman, who initially presented for a neurological consultation about her symptoms suggested Alzheimer’s disease. The patient had been under treatment for more than seven years for type 2 diabetes and developed frequently episodes of hypoglycemia. She was treated the treatment by neurologist as dementia, but the symptoms did not improve, so she was admitted to our hospital. The thyroid function problem had never been suspected at the patient.

During the consultation, we found a big nodule in the left side of the thyroid, with tachycardia and high blood glucose values. Clinically, hyperthyroidism was suspected.

Lab Data: TSH 0.01 mUI/ml (Normal range 0.35–4.78); FT3 9.63 pg/ml (Normal range 2.3–4.2); FT4 3.48 ng/dl (Normal range 0.89–1.76); Glucose 182 mg/dl; HbA1c 5.5%; FBC - Normal

Thyroid ultrasound: A nodule in the left side of thyroid, its dimensions 5.0 × 3.5 cm, with heterogenic structure and microcalcifications. Right lobe of thyroid normal.

Thyroid scan with Tc99: Hot nodule in the left side of thyroid. Uptake 11%.

Head MR: Normal

A treatment with methimazole and β-blockers was started and the diabetes pills was stopped, since a secondary diabetes related to hyperthyroidism developed. Four weeks after the start of the treatment the patients improved, without any symptoms of dementia. The thyroidectomy was recommended.

Conclusions: Since thyroid disease can be associated with various psychiatric symptoms, we recommend checking thyroid function at the patient with psychiatric diseases even in a patient with “possible” Alzheimer’s disease.

hyperthyroidism, psychosis, dementia.

Keywords: hyperthyroidism, psychosis, dementia.