Abstract

PINTO-VALDIVIA, Miguel; RAMIREZ-VELA, Rosa María  and  PINTO-VALDIVIA, José Luis. Thyrotoxic vomiting: A case report. Rev Med Hered [online]. 2015, vol.26, n.1, pp.47-50. ISSN 1018-130X.

Nausea and vomiting, as the main presenting symptoms, are rare manifestations of hyperthyroidism. We report the case of a-76-year old woman complaining of nausea, vomiting and abdominal pain. The physical examination at admission revealed tachycardia, fever, edema, diffuse goiter, and a painful abdomen. An extensive work-up was carried-out, that included abdominal ultrasound, upper endoscopy and abdominal CT-scan that were unrevealing. The initial diagnoses were complicated urine tract infection and cholangitis; however, the use of antibiotics and antiemetics did not resolve the symptoms. Finally, thyroid hormone dosage showed suppressed TSH and high levels of free thyroxine and triiodothyronine. Vomiting ceased soon after the administration of propranolol and methimazole. The patient was discharged without complaints. The pathogenesis of vomiting in patients with hyperthyroidism is unknown, but treatment with beta-blockers and thionamides quickly resolved the symptoms.

Keywords : Hyperthyroidism; Thyrotoxicosis; vomiting; thyroid gland.

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