Severe exogenous thyrotoxicosis caused by medication in Munchausen syndrome: a case report
10.3760/cma.j.cn311282-20220125-00058
- VernacularTitle:药物导致孟乔森综合征患者严重外源性甲状腺毒症1例报告
- Author:
Linlin ZHAO
1
;
Mengxing PAN
;
Yanyan ZHAO
Author Information
1. 郑州大学第一附属医院内分泌与代谢病科，郑州 450052
- Keywords:
Exogenous thyrotoxicosis;
Factitia;
Munchausen syndrome;
Clinical characteristics;
Treatment
- From:
Chinese Journal of Endocrinology and Metabolism
2023;39(11):974-977
- CountryChina
- Language:Chinese
-
Abstract:
We reported a case of a patient with Munchausen syndrome who developed severe exogenous thyrotoxicosis due to medication. A 17-year-old female patient was hospitalized because of palpitation and hands tremor lasting for 4 months and intermittent hyperpyrexia lasting for 3months. There were no signs of goiter, exophthalmos or pretibial myxedema. And the laboratory tests showed hyperthyroxinemia, normal thyroid autoantibodies and low serum thyroglobulin level. In addition, the imaging studies revealed decreased uptaking of radionuclides Te-99 in thyroid static imaging and no abnormal mass of pelvic in MRI. However, the patient denied using any medication of thyroid hormone or health products. Later her mother discovered that the patient was secretly taking unidentified substances. The mass spectrometry analysis showed the unknown medications contained levothyroxine sodium. So the final diagnosis were Munchausen syndrome and exogenous thyrotoxicosis. Unfortunately, the patient refused mental and psychological treatment. In the following two years, she had always taken diverse medications and visited many different hospitals. In summary, Munchausen syndrome has various clinical manifestations and poor prognosis. To address the underlying emotional needs of the patient may be an important measure of the treatment.
