QJM Advance Access published online on September 3, 2008
QJM, doi:10.1093/qjmed/hcn107
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Newly diagnosed thyrotoxicosis in hospitalized patients: clinical characteristics
From the 1Department of Medicine E 2Department of Diagnostic Imaging and 3Endocrine Unit, Meir Medical Center, Kfar-Saba, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Address correspondence to Dr P. Rotman-Pikielny, Department of Medicine E, Meir Medical Center, 59 Tshernihovsky St, Kfar-Saba 95847, Israel. email: pnina.rotman{at}clalit.org.il
Received 15 March 2008 and in revised form 8 August 2008
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Abstract |
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Background: Thyrotoxicosis is often diagnosed in an outpatient setting. The most common symptoms include irritability, heat intolerance, palpitations and weakness. Sometimes, however, thyrotoxicosis is first diagnosed in the hospital setting. The prevalent symptoms in hospitalized patients with newly diagnosed thyrotoxicosis have not been fully characterized.
Aim: To determine the clinical characteristics of patients with thyrotoxicosis newly diagnosed during hospitalization.
Design: A retrospective computer-based search was undertaken to detect patients that were hospitalized in our medical centre during 1999–2006, and discharged with thyrotoxicosis or thyroiditis as the primary diagnosis.
Results: Fifty-eight patients (36F/22M; mean age 52.1 ± 17.5 years) were identified. Weakness, weight loss and palpitations were the most common manifestations (50, 40 and 35%, respectively) and were predominantly present in patients with hyperthyroidism. Sore throat was present in 41% of patients with thyroiditis. Sinus tachycardia and atrial fibrillation occurred in 65.5 and 15.5% of the patients, more common in those with hyperthyroidism. The diagnoses on discharge were Graves’ disease, subacute thyroiditis and multinodular goiter in 39.7, 34.5 and 8.9%, respectively.
Conclusions: Weakness, weight loss and palpitations were the main symptoms in patients diagnosed with thyrotoxicosis during hospitalization. Thyrotoxicosis should be included in the differential diagnosis when patients are admitted to the hospital with those symptoms.