Challenging Cases of Hyperthyroidism

Abstract

This chapter outlines and discusses two patients with thyroid disease who presented unusually complex problems in management. They demonstrate the role of the thyroid specialist in the long-term care of the challenging patient. The thyroid specialist becomes, in some respects, the primary physician in conjunction with the patient’s primary care physician (PCP). It has always been particularly satisfying to me as an endocrinologist to play a major role in the long-term care of a patient. These patients often require the consultation and ongoing care of several specialists and the PCP in a team approach. When the primary medical problem involves the thyroid, the endocrinologist takes on a central role in patient care. Thyroid disease may affect many organ systems and may require the help of a cardiologist, ophthalmologist, dermatologist, surgeon, occasionally a psychiatrist, and even an allergist. The patients discussed here were especially challenging to me and to the other physicians who participated in their care.