title: [L-thyroxine pseudomalabsorption: a factitious disease].
abstract: BACKGROUND
  Thyroxine supplementation of patients with hypothyroidism is usually simple. A few patients, however, continue to present elevated TSH levels despite large doses of L-thyroxine.
  
  
  METHODS
  We report the case of a 71-year-old women who had had a thyroidectomy 10 years earlier and had since been hospitalized repeatedly for profound hypothyroidism. Despite her consistent claims of good adherence to her treatment regimen, we considered the diagnosis of L-thyroxine pseudomalabsorption and confirmed it by thyroid hormone absorption tests.
  
  
  CONCLUSIONS
  L-thyroxine pseudomalabsorption due to concealed poor treatment adherence should be considered after ruling out drug or dietary interference and true organic malabsorption. Diagnosis of this factitious disease can be confirmed by L-thyroxine absorption tests.
authors: Service de nutrition, maladies métaboliques et endocrinologie, Hôpital La Timone, Marseille. lmolines77@yahoo.fr
authors: Laurent
authors: L
authors: Molines
authors: Isabelle
authors: I
authors: Fromont
authors: Nathalie
authors: N
authors: Morlet-Barla
authors: Juan-Patricio
authors: JP
authors: Nogueira
authors: René
authors: R
authors: Valéro
authors: Bernard
authors: B
authors: Vialettes
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D005162:Factitious Disorders / Q000175:diagnosis; D005260:Female; D006044:Goiter, Nodular / Q000601:surgery; D006801:Humans; D007037:Hypothyroidism / Q000188:drug therapy*; D007408:Intestinal Absorption; D008286:Malabsorption Syndromes / Q000175:diagnosis*; D010349:Patient Compliance; D013965:Thyroidectomy; D013974:Thyroxine / Q000008:administration & dosage / Q000378:metabolism* / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D013974:Thyroxine