Crise tireotóxica como diagnóstico diferencial de doença psiquiátrica: relato de caso

Abstract

Thyroid storm is a rare condition, which reflects an extreme physiological state within the thyrotoxicosis spectrum. This compromises various body systems, including the central nervous system. Although the changes in mood and behavior can occur due to thyrotoxicosis, severe neuropsychiatric characteristics such as psychosis, seizures or coma are rarely found. The aim of this study was to show a case report of a patient, 41 years that started with sudden agitation, tachylalia and religious delusion. It was previously healthy with no comorbidities. Clinical and laboratory findings (TSH suppressed and T4> 6) suggested Thyroid storm, scoring 55 points for the diagnostic criteria by Burch and Wartoksky (temperature: 37.7; psychosis, heart rate: 135; precipitating factor). The pathophysiology of neuropsychiatric symptoms in thyroid storm is still unclear and some theories are proposed. The neurological irreversible even with the institution of appropriate drug therapy can happen as evidenced in the patient of this case report, even though he had received drug treatment recommended by the literature, she remained with neuropsychiatric manifestations, although other signs and symptoms of thyroid storm had It has been eliminated. Key words: Thyroid Crisis; Hyperthyroidism; Mental Disorders; Psychotic Disorders