Graves' disease presenting as paranoid schizophrenia in a Nigerian woman: a case report

Ogah, Okechukwu S; Timeyin, Anne O; Kayode, Oluyinka A; Otukoya, Adedeji S; Akinyemi, Rufus; Adeyemi, Folashade I

doi:10.4076/1757-1626-2-6708

Cited by 8 publications

(8 citation statements)

References 7 publications

(8 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Adrenergic hyperactivity induces psychiatric symptoms in hyperthyroidism, however. GD patients presenting only delusion like our patient are uncommon [5,6]. …”

Section: Discussionmentioning

confidence: 99%

A patient with Graves’ disease showing only psychiatric symptoms and negativity for both TSH receptor autoantibody and thyroid stimulating antibody

2012

View full text Add to dashboard Cite

BackgroundBoth thyroid stimulating hormone (TSH) and thyroid stimulating antibody (TSAb) negative Graves’s disease (GD) is extremely rare. Here we present such a patient.Case presentationThe patient was a 76-year-old woman who was diagnosed as having schizophrenia forty years ago. She did not show characteristic symptoms for hyperthyroidism, such as swelling of thyroid, exophthalmos, tachycardia and tremor, however, she showed only psychomotor agitation. Serum free triiodothyronine and free thyroxine levels were elevated and TSH level was suppressed, suggesting the existence of hyperthyroidism. However, both the first generation TSH receptor autoantibody (TRAb1) and the thyroid stimulating autoantibody (TSAb) were negative. Slightly increased blood flow and swelling was detected by thyroid echography. Thyroid scintigraphy demonstrated diffuse and remarkably elevated uptake of 123I uptake. Finally, we diagnosed her as having GD. She was treated by using methimazole, and hyperthyroidism and her psychiatric symptoms were promptly ameliorated.DiscussionWe experienced a patient with GD who did not show characteristic symptoms except for psychiatric symptoms, and also showed negativity for both TRAb1 and TSAb. Thyroid autoantibody-negative GD is extremely rare. Thyroid scintigraphy was useful to diagnose such a patient.

show abstract

“…Adrenergic hyperactivity induces psychiatric symptoms in hyperthyroidism, however. GD patients presenting only delusion like our patient are uncommon [5,6]. …”

Section: Discussionmentioning

confidence: 99%

A patient with Graves’ disease showing only psychiatric symptoms and negativity for both TSH receptor autoantibody and thyroid stimulating antibody

2012

View full text Add to dashboard Cite

show abstract

“…In this study, our results also suggest that the T allele of rs2274736 is a risk allele for schizophrenia. In the literature, there were case reports that some Graves' disease patients had psychiatric syndromes like paranoid schizophrenia (Adams et al, 2004; Ogah et al, 2009), and this was partially due to the influence of high thyroid hormone on brain function.…”

Section: Discussionmentioning

confidence: 99%

Two non-synonymous markers in PTPN21, identified by genome-wide association study data-mining and replication, are associated with schizophrenia

Chen

Lee

Fanous

et al. 2011

Schizophrenia Research

View full text Add to dashboard Cite

We conducted data-mining analyses of genome wide association (GWA) studies of the CATIE and MGS-GAIN datasets, and found 13 markers in the two physically linked genes, PTPN21 and EML5, showing nominally significant association with schizophrenia. Linkage disequilibrium (LD) analysis indicated that all 7 markers from PTPN21 shared high LD (r2>0.8), including rs2274736 and rs2401751, the two non-synonymous markers with the most significant association signals (rs2401751, P=1.10×10−3 and rs2274736, P=1.21×10−3). In a meta-analysis of all 13 replication datasets with a total of 13,940 subjects, we found that the two non-synonymous markers are significantly associated with schizophrenia (rs2274736, OR=0.92, 95% CI: 0.86–0.97, P=5.45×10−3 and rs2401751, OR = 0.92, 95% CI: 0.86–0.97, P=5.29×10−3). One SNP (rs7147796) in EML5 is also significantly associated with the disease (OR = 1.08, 95% CI: 1.02-1.14, P=6.43×10−3). These 3 markers remain significant after Bonferroni correction. Furthermore, haplotype conditioned analyses indicated that the association signals observed between rs2274736/rs2401751 and rs7147796 are statistically independent. Given the results that 2 non-synonymous markers in PTPN21 are associated with schizophrenia, further investigation of this locus is warranted.

show abstract

“…However, psychosis, as the first presenting feature of thyrotoxicosis, is extremely rare. Since Von Basedow described the first case of manic psychosis in a patient with exophthalmic goiter over a century ago ( 2 ), a few cases have been reported, including major depressive ( 11 ), manic ( 12 ), paranoid ( 3 ), and schizophreniform disorders ( 4 - 6 ). Indeed, thyrotoxicosis is now a recognized cause of organic psychosis.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

“…The first case of thyrotoxic psychosis was described over a century ago ( 2 ). Since then, many other cases have been reported, mostly from developed countries ( 3 - 5 ), while only one case of psychosis associated with Graves’ disease has been reported in Nigeria ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Graves’ Thyrotoxicosis Presenting as Schizophreniform Psychosis: A Case Report and Literature Review

Ugwu

Maluze

Onyebueke

2016

Int J Endocrinol Metab

View full text Add to dashboard Cite

Psychosis, as the first presentation of thyrotoxicosis, is extremely rare. Consequently, it is often misdiagnosed as a primary psychiatric disorder, especially in developing countries with poor healthcare facilities. Owing to the high level of illiteracy and lack of knowledge, it is fairly common to ascribe many illnesses to spiritual attacks in Nigeria and other African countries, especially when the disease is rarely seen or is associated with psychiatric manifestations. Herein, we present the case of a teenage female Nigerian and review the literature on this subject.

show abstract

Graves' disease presenting as paranoid schizophrenia in a Nigerian woman: a case report

Cited by 8 publications

References 7 publications

A patient with Graves’ disease showing only psychiatric symptoms and negativity for both TSH receptor autoantibody and thyroid stimulating antibody

A patient with Graves’ disease showing only psychiatric symptoms and negativity for both TSH receptor autoantibody and thyroid stimulating antibody

Two non-synonymous markers in PTPN21, identified by genome-wide association study data-mining and replication, are associated with schizophrenia

Graves’ Thyrotoxicosis Presenting as Schizophreniform Psychosis: A Case Report and Literature Review

Contact Info

Product

Resources

About