Thyrotoxic vomiting.

Abstract

In seven patients vomiting played an important part in the presentation of thyrotoxicosis. Vomiting does not always indicate severe thyroid disease, and the diagnosis in patients presenting with this symptom may be long delayed.

Vómito tirotóxico. A propósito de un caso

“…Inicialmente, se planteó que el exceso de hormonas tiroideas circulantes estimula de manera directa el centro quimiorreceptor del cerebro (1,5); sin embargo, también se ha planteado que la hipomagnesemia, causada por el exceso de hormonas tiroideas, afectaría de manera directa a la musculatura lisa del esfínter pilórico o alteraría la inervación autonómica del tracto gastrointestinal superior; provocando un peristaltismo inverso del tracto gastrointestinal superior (3). Otro posible mecanismo sería el incremento de la actividad beta adrenérgica por aumento del número de receptores (1,3), lo cual explicaría la rápida mejoría de los síntomas con el uso de beta-bloqueadores, aún antes de normalizar los niveles de hormonas tiroideas (4,12).…”

A case of thyrotoxic hyperemesis

“…2,6 • Lack of awareness about the association between vomiting and hyperthyroidism might mislead clinicians to an alternate diagnosis and cause a marked delay in the diagnosis; 7 years in one case report. 9 • Therefore, the possibility of hyperthyroidism should be considered in cases of refractory unexplained vomiting, especially when there is past history of thyroid dysfunction.…”

Nausea and Vomiting as Major Presenting Symptoms of Thyrotoxicosis

“…Increased thyroid hormone is known to cause a generalized increase in gut motility [25]. Tyrotoxicosis may cause hyperperistalsis resulting in a relative outlet dysfunction.…”

“…In our three cases no patient had hypercalcemia. Hyperemesis associated with hyperthyroidism occurs predominantly in females [3,25]; a likely emetic factor estrogen. Hyperthyroidism may potentiate this effect, as levels of estrogen are raised in thyrotoxicosis [29].…”