The 509th case: fatigue, sleepiness, mood disorder, and hypothyroidism

VernacularTitle:第509例——乏力、嗜睡、心境障碍、甲状腺功能减退
Author: Liling LIN ¹ ; He LIU ; Fan PING ; Xiaofeng CHAI ; Naishi LI ; Xiaolan LIAN
Author Information

1. 中国医学科学院　北京协和医学院　北京协和医院检验科，北京　100730
Keywords: Hypothyroidism; Lethargy; Fatigue; Isolated central hypothyroidism
From: Chinese Journal of Internal Medicine 2024;63(9):911-916
CountryChina
Language:Chinese
Abstract: A 28-year-old woman presented with a 4-year history of fatigue and sleepiness and was found to have central hypothyroidism and mood disorder. The patient had normal thyroid volume and did not show any other pituitary axis involvement. Over the course of the disease, her symptom improvement matched with the free thyroxine (FT 4) rebound and the adjustment of antipsychotic medication. The patient′s grandmother had central hypothyroidism, and her mother and uncle had lowered or inappropriately normal thyroid stimulating hormone. Hence, genetic involvement was highly suspected, but whole exon sequencing did not reveal a pathogenic variant. Levothyroxine tablets were prescribed to maintain a normal median level of FT 4, and mood disorder medications were adjusted by specialists. Isolated central hypothyroidism is extremely rare, and we report this case aiming to raise awareness of this condition.