Summary
A patient with Graves’ disease remained clinically and biochemically hyperthyroid after intravenous therapeutic131I, although thyroidal uptake fell to normal. Previously she had taken antithyroid drugs irregularly and vomited twice after oral131I. She was treated with carbimazole and thyroxine 0.2 mg daily because of severe exophthalmos. However, she maintained her hypermetabolic state by surreptitiously taking thyroxine in excess of the prescribed dose. When drug treatment was stopped under supervision she rapidly became euthyroid. By tracing prescriptions supplied to the patient it was shown that she had obtained amounts of thyroxine grossly in excess of her requirements.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bricaire, H., Moreau, L., Joly, J., Saltiel, H., Milgrom, E. 1967. Les thyreotoxicoses factices. Revue Francaise. L’Endocrinologie Clinique, Nutrition et Metabolisme 8, 99.
Chamovitz, D. L., Sleisenger, M. H., Freedberg, A. S. 1951. Thyrotoxicosis factitia: measurement of the thyroid gland131I uptake and serum protein-bound131I. Amer. J. Med. 11, 255.
Gorman, C. A., Wahner, H. W., Tauxe, W. N. 1970. Metabolic malingerers; patients who deliberately induce or perpetuate a hypermetabolic or hypometabolic state. Amer. J. Med. 48, 708.
Hamilton, C. R., Maloof, F. 1973. Unusual types of hyperthyroidism. Medicine 52, 195.
Harvey, R. F. 1973. Thyroxine “addicts”. Brit. Med. J. ii, 35.
Hooper, M. J., Ratcliffe, J. G., Ratcliffe, W. A., Spencer, C. A., McLarty, D. G., Alexander, W. D. 1975. Thyroid function in patients in clinical remission after medical treatment of thyrotoxicosis. J. Clin. Endocr. Metab. 40, 807.
Koutras, D. A., Alexander, W. D., Harden, R. McG., Wayne, E. 1964. Effect of small iodine supplements on thyroid function in normal individuals. J. Clin. Endocr. Metab. 24, 857.
Rose, E., Sanders, T. P., Webb, W. L., Hines, R. C. 1969. Occult factitial thyrotoxicosis: thyroxine kinetics and psychological evaluation in three cases. Ann. Int. Med. 71, 309.
Skanse, B. T., Riggs, D. S. 1948. Thyrotoxicosis factitia (alimentary thyrotoxicosis). J. Clin. Endocr. 8, 532.
Wayne, E. J., Koutras, D. A., Alexander, W. D. 1964. Clinical aspects of iodine metabolism. pp. 229–236. Blackwell, Oxford.
Werner, S. C. 1969. Classification of the eye changes in Graves’ disease. J. Clin. Endocr. Metab. 29, 982.
Zellmann, H. E. 1972. Hyperthyroidism. Med. clinics North Amer. 56, 717.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ferriss, J.B., Hooper, M.J. Thyrotoxicosis factitia complicating Graves’ disease. IJMS 145, 260–262 (1976). https://doi.org/10.1007/BF02938957
Issue Date:
DOI: https://doi.org/10.1007/BF02938957