Rare presentations of hyperthyroidism--Basedow's paraplegia and pancytopenia.
Typical presentations of hyperthyroidism are palpitation, nervousness, tremor, malaise, and weight loss. Hyperthyroidism affects nearly every system in the body, and some patients may manifest neurologic or hematologic symptoms. Atypical presentations of hyperthyroidism often pose a great challenge in diagnosis and treatment. We report a case of Basedow's paraplegia and pancytopenia that was precipitated by hyperthyroidism. The unusual manifestations led to unnecessary examinations and delayed the treatment of hyperthyroidism. The classical symptoms of Basedow's paraplegia are subacute symmetric weakness of the lower extremities with areflexia and sparing sensation or sphincter involvement. Control of the hyperthyroidism mitigated the neurologic and hematologic complications and prevented unnecessary studies.
Emergency Department, Chi-Mei Medical Center, Tainan, Yungkang 710, Taiwan.
Yi-Hsien
YH
Chen
Hung-Jung
HJ
Lin
Kuo-Tai
KT
Chen
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D013956:Antithyroid Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006980:Hyperthyroidism / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008713:Methimazole / Q000627:therapeutic use; D010198:Pancytopenia / Q000209:etiology; D010264:Paraplegia / Q000209:etiology; D011433:Propranolol / Q000627:therapeutic use
D000319:Adrenergic beta-Antagonists; D013956:Antithyroid Agents; D008713:Methimazole; D011433:Propranolol