گزارش 10 مورد تيروتوكسيكوز با تظاهرات غيرمعمول

REPORT OF 10 CASES WITH UNUSUAL MANIFESTATIONS IN THYROTOXICOSIS

BACKGROUND AND OBJECTIVE: Diagnosis of hyperthyroidism and graves disease are not difficult due to typical symptoms. Sometimes manifestations of this disease are unusual. So final clinical diagnosis is important. CASE: In this study, 10 cases with thyrotoxicosis along with unusual manifestations were surveyed. Of these, 6 cases were male and 4 cases were female. They were at the 17-68 age group with the mean of 48.2. The frequency of unusual symptoms were as follows: general pruritis without skin lesion (3 cases), anorexia and vomiting (3 cases), hypokalemic paralysis (2 cases) , dysphagia with recurrent pulmonary aspiration (1 case), pretibial myxedema (1 case) and means lerman scratch (1 case). This interval between the beginning of symptoms and final diagnosis was different from 10 to 120 days. The thyroid function test showed hyperthyroidism in all cases. Another underlying disorder was not detected. All symptoms of patients were removed after antithyroid drugs therapy except pretibial myxedema (1case) and exophthalmos (2 cases). There was no complication during 18 month antithyroid therapy after interruption of drug, relapse of disease was seen in 3 cases. CONCLUSION: With regard to different manifestation of thyrotoxicosis, this disease should be considered in differential diagnosis, especially in older age groups with gastrointestinal, cardiac, cutaneous and musculoskeletal complaints.