[L-thyroxine pseudomalabsorption: a factitious disease].
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.
Molines
Laurent
L
Service de nutrition, maladies métaboliques et endocrinologie, Hôpital La Timone, Marseille. lmolines77@yahoo.fr
Fromont
Isabelle
I
Morlet-Barla
Nathalie
N
Nogueira
Juan-Patricio
JP
Valéro
René
R
Vialettes
Bernard
B
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
D013974:Thyroxine