Presentation Type
Poster
Discipline Track
Patient Care
Abstract Type
Case Report
Abstract
Introduction: Hypothyroidism is a condition caused by the thyroid gland's insufficient production of thyroid hormones. This affects 13.95% of the population according to data from this year. Long-term untreated hypothyroidism, which is not frequently seen, can lead to serious health concerns as well as apparent physical signs like fatigue, cognitive difficulties, dry skin, hair loss, and constipation. While most of the people in the US may be able to receive treatment for this debilitating disease, there are specific vulnerable populations that due to socioeconomic difficulties, may not have access to medications.
Case Presentation: A 52-year-old Hispanic woman with a known history of hypothyroidism diagnosed 20 years ago who had not received treatment, presented to the emergency department after experiencing generalized weakness and syncopal episodes for months. She stated that even though she knew of her disease, she was not able to afford the medication for a while. Upon assessment, the patient appeared weak and fatigued, without signs of respiratory distress. Physical examination revealed clinical signs of hypothyroidism, including cold, pale, and dry skin, but there was no evidence of lower extremity swelling, suggestive of myxedema. Initial laboratory showed several abnormalities. A Hg of 8.8, Hct 25.8, Plt 179 Na 132 creatinine 1.3, AST 37, ALT 31, Lipase 479, . TSH of 146, T4 free 0.1, BNP 479. Orthostatic vital signs and a digital rectal exam were negative. EKG reported sinus rhythm, rate 95, Axis normal, QTc 447, and chest x-ray with AP view suggestive of cardiomegaly The patient was started on levothyroxine at an initial dose of 88 mcg daily and after a couple of days, her symptoms started to improve.
Discussion: The consequences of chronic, untreated hypothyroidism can be severe, as demonstrated in this case. The patient presented with a range of physical changes that are now rare to see since we have a way to supply the same hormone. These changes further highlight the negative impact of untreated hypothyroidism on the body, increasing the risk of complications such as mental changes and anemia. Prompt initiation of levothyroxine therapy is crucial to alleviate the symptoms and restore normal thyroid function. This case emphasizes the importance of early diagnosis and appropriate management to mitigate the adverse effects of hypothyroidism and ensure the patient's overall well-being. It also demonstrates the need for better healthcare access to different vulnerable populations who still do not have access to this medication. Therefore, early diagnosis and appropriate thyroid hormone replacement therapy are crucial in managing this condition's effects.
Academic/Professional Position
Resident
Mentor/PI Department
Internal Medicine
Recommended Citation
Gonzalez Morales, Elimar; Gomez Casanovas, Jose; Cho, Eunbee; Durazo Gonzalez, Yareli; Haj-Yahya, Khairiya; and Suarez Parraga, Andres, "Exploring the Long-Term Consequences of Neglected Hypothyroidism Patient at South Texas: A Case Report" (2024). Research Symposium. 34.
https://scholarworks.utrgv.edu/somrs/2024/posters/34
Included in
Exploring the Long-Term Consequences of Neglected Hypothyroidism Patient at South Texas: A Case Report
Introduction: Hypothyroidism is a condition caused by the thyroid gland's insufficient production of thyroid hormones. This affects 13.95% of the population according to data from this year. Long-term untreated hypothyroidism, which is not frequently seen, can lead to serious health concerns as well as apparent physical signs like fatigue, cognitive difficulties, dry skin, hair loss, and constipation. While most of the people in the US may be able to receive treatment for this debilitating disease, there are specific vulnerable populations that due to socioeconomic difficulties, may not have access to medications.
Case Presentation: A 52-year-old Hispanic woman with a known history of hypothyroidism diagnosed 20 years ago who had not received treatment, presented to the emergency department after experiencing generalized weakness and syncopal episodes for months. She stated that even though she knew of her disease, she was not able to afford the medication for a while. Upon assessment, the patient appeared weak and fatigued, without signs of respiratory distress. Physical examination revealed clinical signs of hypothyroidism, including cold, pale, and dry skin, but there was no evidence of lower extremity swelling, suggestive of myxedema. Initial laboratory showed several abnormalities. A Hg of 8.8, Hct 25.8, Plt 179 Na 132 creatinine 1.3, AST 37, ALT 31, Lipase 479, . TSH of 146, T4 free 0.1, BNP 479. Orthostatic vital signs and a digital rectal exam were negative. EKG reported sinus rhythm, rate 95, Axis normal, QTc 447, and chest x-ray with AP view suggestive of cardiomegaly The patient was started on levothyroxine at an initial dose of 88 mcg daily and after a couple of days, her symptoms started to improve.
Discussion: The consequences of chronic, untreated hypothyroidism can be severe, as demonstrated in this case. The patient presented with a range of physical changes that are now rare to see since we have a way to supply the same hormone. These changes further highlight the negative impact of untreated hypothyroidism on the body, increasing the risk of complications such as mental changes and anemia. Prompt initiation of levothyroxine therapy is crucial to alleviate the symptoms and restore normal thyroid function. This case emphasizes the importance of early diagnosis and appropriate management to mitigate the adverse effects of hypothyroidism and ensure the patient's overall well-being. It also demonstrates the need for better healthcare access to different vulnerable populations who still do not have access to this medication. Therefore, early diagnosis and appropriate thyroid hormone replacement therapy are crucial in managing this condition's effects.