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Ann Geriatr Med Res > Volume 15(4); 2011 > Article
Journal of the Korean Geriatrics Society 2011;15(4):245-249.
DOI: https://doi.org/10.4235/jkgs.2011.15.4.245    Published online December 31, 2011.
A Case of Thyroid Storm with Delayed Diagnosis in Old Aged Person with Parkinson's Disease
Youn Zoo Cho, Mahn Lee, Hyun Jung Song, Mi Young Lee, Hye Jin Yoon, Won Min Hwang, Sung Ro Yun, Byung Joon Kim, Keun Young Park, Dong Mee Lim
1Department of Internal Medicine, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
2Department of Nephrology, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea.
3Department of Endocrinology and Metabolism, Konyang University Hospital, Konyang University College of Medicine, Daejeon, Korea. mdldm@hanmail.net
파킨슨병이 동반된 노인환자에서 진단이 늦어진 갑상선 중독 발증 1례
조윤주1, 이만1, 송현정1, 이미영1, 윤혜진1, 황원민2, 윤성로2, 김병준3, 박근용3, 임동미3
건양대학교 의과대학 내과학교실1,건양대학교병원 신장내과2,내분비내과3
Abstract
A thyroid storm is a potentially fatal complication of hyperthyroidism. Early diagnosis and treatment is essential for reducing morbidity and mortality. Older patients with hyperthyroidism tend to have fewer hypermetabolic signs and increased signs of weight loss, depression, lethargy, cardiac arrhythmia, and apathetic mood. Additionally, comorbid diseases and drug history can affect thyroid function and symptoms. Here, we report an older patient with a thyroid storm and accompanied features of Parkinson's disease. She presented with generalized weakness, delirium, and anxiety. Laboratory findings were consistent with hyperthyroidism. She became drowsy with no precipitating factors. High fever, meningism, and atrial fibrilation occurred with no obvious sources. Suspecting a diagnosis of a thyroid storm, she was treated with an antithyroid drug, Lugol's solution, hydrocortisone, and supportive management. After these treatments, her clinical condition recovered and the neurological signs resolved.
Key Words: Thyroid storm, Parkinson's disease, Apathetic hyperthyroidism
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