title: [Factitious hyperthyroidism caused by L-thyroxin abuse. Case report].
abstract: A 43 years old female was treated for 8 months with antithyroid drugs because of a difficult adjustable hyperthyroidism. In spite of this massive antithyroid therapy a threatening deterioration of the clinical picture occurred. The reason for it was the secret intermittent intake of up to 1200 micrograms lT4 daily motivated by private problems. The difficulties of a differential diagnosis between a thyrotoxicosis factitia and an endogenous hyperthyroidism is stressed. One should always consider a thyrotoxicosis factitia in the case of suggestion of a psychopathia and when thyroid hormone medication is used for suppressive thyroid hormone therapy or as a prophylaxis of goiter recurrence. In addition overweight, major personality disorders and resistance to antithyroid drugs are indicative for thyroid hormone abuse. Important indicators for the differentiation between a thyroid hormone abuse and an endogenous hyperthyroidism are a lack of technetium- or radioiodine-uptake in the thyroid and suppressed levels of thyroglobulin.
mesh_terms: D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000209:etiology*; D008875:Middle Aged; D012651:Self Medication; D019966:Substance-Related Disorders / Q000150:complications*; D013974:Thyroxine
chemical_list: D013974:Thyroxine
vernacular_title: Hyperthyreosis factitia durch L-Thyroxinabusus (ein Fallbericht).