title: An unusual presentation of hypothyroidism.
abstract: We describe a case of a 42-year-old male, with a 5-year history of recurrent gum bleeding, easy bruising, and chronic fatigue who presented for management of possible bleeding complications prior to a planned dental procedure. After extensive work-up, the patient was diagnosed with acquired von Willebrand Disease and underlying hypothyroidism with a thyrotropin (TSH) of 321 mIU/L (0.35-5.5) and total thyroxine (T(4)) of less than 1 microg/dL (4.5-12.5). He was started on levothyroxine and therapy and when compliant with treatment, the mucosal bleeding and symptoms of hypothyroidism were resolved. A subsequent TSH and total T(4) samples were drawn and found to be 6.3 mIU/L and 4.1 microg/dL, respectively.
authors.affiliation: Department of Medicine, Mercy Hospital and Medical Center, Chicago, Illinois, USA.
authors.forename: Sonia
authors.initials: S
authors.lastname: Soni
authors.forename: Gundeep
authors.initials: G
authors.lastname: Singh
authors.forename: Subia
authors.initials: S
authors.lastname: Yasir
authors.forename: Betul
authors.initials: B
authors.lastname: Hatipoglu
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005884:Gingival Hemorrhage / Q000209:etiology; D006801:Humans; D007037:Hypothyroidism / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood / Q000627:therapeutic use*; D016896:Treatment Outcome; D014842:von Willebrand Diseases / Q000209:etiology
chemical_list: D013972:Thyrotropin; D013974:Thyroxine