Abstract
Objectives: Hypothyroidism is usually detected in an outpatient setting, but might be diagnosed during hospitalization. The prevalent symptoms are not fully defined. This study aimed to determine the clinical characteristics of in-patients with overt hypothyroidism. Methods: The medical records of 23 inpatients (16F/7M, age 61.5 ± 21.8 years), who had 29 admissions with a primary diagnosis of hypothyroidism from January 1997 to December 2007 were retrospectively reviewed. They comprised 0.01% of all adult medical admissions during the study. Results: Fifty-five percent had a pre-admission diagnosis of hypothyroidism, 10% were nursing home residents and 38% had cognitive decline. Sixtynine percent presented with multiple complaints, mostly weakness and constipation, reported by 89% and 68%, respectively. Thyrotropin level was 74.3 ± 53.5 mIU/L (normal 0.23 - 4) and free thyroxine was 0.43 ± 0.29 ng/dL (normal 0.8 - 2). Elevated creatinine phosphokinase, anemia (hemoglobin 12 g/dL) and hyponatremia (sodium 135 mEq/L) were present in 89%, 62%, and 13%, respectively. Conclusions: Overt hypothyroidism during hospitalization occurs infrequently and mostly in patients with previously diagnosed hypothyroidism. Clinical manifestations include multiple non-specific symptoms, mainly weakness and constipation, while typical “hypothyroid” symptoms such as cold intolerance and weight gain are often overlooked. A high index of suspicion is needed to detect hypothyroidism in the hospital setting.
Highlights
Hypothyroidism, one of the most common chronic disorders in western societies, is often diagnosed and treated in an outpatient setting
The aim of our study was to determine the clinical characteristics of hospitalized patients who were discharged with a primary diagnosis of overt hypothyroidism
This study focuses on the clinical characteristics of patients who were diagnosed with overt hypothyroidism in an inpatient setting
Summary
Hypothyroidism, one of the most common chronic disorders in western societies, is often diagnosed and treated in an outpatient setting. Cold intolerance, dyspnea, weight gain, constipation, and cognitive dysfunction [1,2,3]. Hypothyroidism is diagnosed in the hospital setting. This patient population, often elderly with comorbidities and sometimes cognitively impaired, may present with nonspecific symptoms, as was reported previously in older studies from the 1980s [4,5,6]. To the best of our knowledge, there are no recent studies addressing the clinical manifestations of patients with overt hypothyroidism during hospitalization. The aim of our study was to determine the clinical characteristics of hospitalized patients who were discharged with a primary diagnosis of overt hypothyroidism
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