Acute Psychosis in a Patient with Hashimoto's Thyroiditis

橋本氏甲狀腺炎引發之急性精神病

蔡宗益(Zon-Yi Tsai) ； 帥華安(Hua-An Shuai) ； 王家駿(Chia-Chun Wang) ； 蔡光洋(Guang-Yang Tsai)

《台灣精神醫學》 23卷4期 (2009/12) Pp. 337-342

https://doi.org/10.29478/TJP.200912.0010

摘要

目的：一橋本氏甲狀腺炎患者，病程中呈現甲狀腺機能亢進並引發急性精神病。病例報告：一位43歲男性，一年前開始感到心悸，住院前一週突然出現妄想及幻覺，住院第三天呈現譫妄現象，經檢查診斷橋本氏甲狀腺炎，以抗精神病藥及抗甲狀腺藥物治療後精神及身體症狀消失。考量疾病病程發展，身、心症狀出現之時間關聯性以及對治療反應，診斷為橋本氏甲狀腺炎引發急性精神病。在甲狀腺藥物治療下，未再出現精神症狀。結論：當個案出現急性精神症狀併甲狀腺功能異常，宜檢驗自體抗體，考慮橋本氏甲狀腺炎引發精神疾病可能性。

關鍵字

精神病 ； 橋本氏甲狀腺炎 ； 甲狀腺機能亢進 ； 譫妄

並列摘要

Objective: We report a patient with Hashimoto's thyroiditis (HT) who presented with hyperthyroidism and psychotic symptoms. Case report: A 43-yearold male patient had suffered from palpitations of the heart for one year. One week before admission, he had a sudden onset of delusion and hallucinations. Three days after admission, he developed delirium. The results of the laboratory examinations showed HT in hyperthyroid state with high level of anti-thyroid antibodies. After having received anti-thyroid drugs and antipsychotic drugs, he was observed to have complete recovery of the physical and psychotic symptoms. Based on the progressive nature of the course of this patient’s disease and the response to treatment, we diagnosed the patient to have psychotic disorder due to HT. He had been well in the follow-up. Conclusion: This case report suggests that screening of serum anti-thyroid antibodies for any patient with atypical psychosis with thyroid dysfunction is needed, and that Hashimoto's disease should be considered in any patient with atypical psychosis, as prompt recognition and management can lead to an excellent treatment outcome.

並列關鍵字

psychosis ； Hashimoto's thyroiditis ； hyperthyroidism ； delirium

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