title: 'Apathetic' thyrotoxicosis presenting with hypercalcaemia and spurious normalization of serum thyroid hormone levels.
abstract: A patient with thyrotoxicosis presented with weight loss and hypercalcaemia, leading to an erroneous diagnosis of occult malignant disease. Intercurrent illness and drug treatment of hypercalcaemia in this patient caused a depression of circulating thyroid hormone levels, leading to a delay in diagnosis. Radionuclide studies of thyroid function, in contrast, consistently suggested a thyrotoxic state. It is suggested that in this situation, radionuclide studies may give a more accurate assessment of thyroid status than biochemical tests, which may be difficult to interpret in the presence of non-thyroidal illness.
mesh_terms: D013956:Antithyroid Agents / Q000627:therapeutic use; D001835:Body Weight; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D008875:Middle Aged; D013963:Thyroid Hormones / Q000097:blood*; D013971:Thyrotoxicosis / Q000097:blood / Q000150:complications*; D013973:Thyrotropin-Releasing Hormone / Q000097:blood; D013974:Thyroxine / Q000097:blood; D014284:Triiodothyronine / Q000097:blood
chemical_list: D013956:Antithyroid Agents; D013963:Thyroid Hormones; D014284:Triiodothyronine; D013973:Thyrotropin-Releasing Hormone; D013974:Thyroxine