Apathetic thyrotoxicosis- how to treat?
A 39-year-old daily wage worker was referred for surgical opinion because of a 5-month history of anorexia, 15 kg weight loss, altered bowel habit with constipation and colicky upper abdominal pain. He had become depressed and withdrawn over the preceding 3 months and, because of his weakness, had been unable to continue with his work. Examination showed a thin, lethargic man with gross tissue loss and extreme proximal weakness of the limbs which resulted in difficulty in walking, rising from a chair unaided, and inability to lift his hands above the level of his waist when standing. In the abdomen, a firm, poorly mobile mass could be palpated in the left upper quadrant and, because of the general appearance of the patient, a diagnosis of large bowel carcinoma in the region of the splenic flexture was considered. Apathetic thyrotoxicosis was diagnosed. How to treat this condition?
@anushtup Apathetic thyrotoxicosis is an atypical though not rare manifestation of hyperthyroidism. The cardinal features are apathy and depression, as opposed to hyperkinesis and mental alertness in the usual thyrotoxic patient, and are unassociated with the usual signs and symptoms of hyperthyroidism, making the diagnosis difficult. Medication – drugs called beta-blockers (e.g. propranolol), can be used to reduce the symptoms of thyrotoxicosis such as the heart rate, anxiety or sweating. However, to treat the raised hormone levels, different medication called carbimazole or another called propylthiouracil is used.