Our purpose in this contribution is to call attention to two points that are not infrequently illustrated in cases of decreased thyroid functioning:
The classic mental picture of myxedema is easily recognized; but decreased thyroid secretion may show itself through mental symptoms and signs which obscure the actual cause of the disease and mislead the diagnostician.
When mental derangement is severe and consists both in a slowing up of the intellect and in periods of intense fear, restlessness, hallucinations and delusions, coupled with active resistance, not only does it obscure the disease picture but it may also make it impossible for the physician to apply a basal metabolism test or even to test the blood pressure. In these cases a wrong diagnosis is often made.
To illustrate these points, the records of this hospital show several cases in which the possibility of hypothyroidism was present but in which this possibility
HAYWARD EP, WOODS AH. MENTAL DERANGEMENTS IN HYPOTHYROIDISM: THEIR MISLEADING EFFECTS IN DIAGNOSIS. JAMA. 1931;97(3):164–165. doi:10.1001/jama.1931.02730030014006
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