case_images: PMC10366534_01
case_images: Thyroid hormone level fluctuations in the four phases. (A) Time series of F-T3. Dotted lines indicate the reference range for F-T3. (B) Time series of F-T4. Dotted lines represent the reference range for F-T4. (C) The four treatment phases derived from the fluctuations in thyroid hormone levels. There is an initial period of extremely high F-T3 and F-T4 levels (phase A), followed by a decline in these levels (phase B). These levels subsequently increase (phase A') and then gradually decrease until they approach the reference range (phase B'). The thyroid-stimulating hormone levels measured simultaneously with the F-T3 and F-T4 levels were consistently below the detection sensitivity (<0.01 muU/mL). F-T3, free triiodothyronine; F-T4, free thyroxine.
case_images: fpsyt-14-1219049-g001.jpg
case_images: PMC10366534_01_fpsyt-14-1219049-g001.jpg
case_images: fig1
case_images: Table 1; Figure 1. Figure 2 illustrates the patient's treatment course, which involved hospitalization on day 1, discharge on day 130, and subsequent hospital visits on days 135 and 140. At the time of admission, the patient had extremely high levels of F-T3 and F-T4, which gradually decreased until day 20, increased again around day 40, and then decreased steadily until discharge. Throughout treatment, TSH levels remained consistently below the detection sensitivity (<0.01 muU/mL).
case_images: Treatment course for psychotic symptoms in the four phases. The horizontal axis indicates days of hospitalization, and three variables (psychotic symptoms, antipsychotic treatment, and phases of thyroid hormone level fluctuations) are shown. BNS, blonanserin transdermal patch; PAL, paliperidone palmitate oral route; PAL-LAI, long-acting injectable paliperidone palmitate.
case_images: fpsyt-14-1219049-g002.jpg
case_images: PMC10366534_01_fpsyt-14-1219049-g002.jpg
case_images: fig2
case_images: Table 1; Figure 1. Figure 2 illustrates the patient's treatment course, which involved hospitalization on day 1, discharge on day 130, and subsequent hospital visits on days 135 and 140. At the time of admission, the patient had extremely high levels of F-T3 and F-T4, which gradually decreased until day 20, increased again around day 40, and then decreased steadily until discharge. Throughout treatment, TSH levels remained consistently below the detection sensitivity (<0.01 muU/mL). During phase A, for managing thyrotoxicosis, the patient received treatment with 8 mg of dexamethasone, 200 mg of potassium iodide, 2 mg of bisoprolol fumarate, and 30 mg of methimazole, while her psychotic symptoms were treated with a 40 mg/day blonanserin transdermal patch (details are shown in Figures 2, 3). The treatment course is shown in Figures 2, 3.
case_images: Treatment course for hyperthyroidism in the four phases. The horizontal axis indicates days of hospitalization, and the three variables (treatment with DEX and KI; BF, MMI, and LT4; and phases of thyroid hormone level fluctuations) are shown. BF, bisoprolol fumarate; DEX, dexamethasone; KI, potassium iodide; LT4, levothyroxine; MMI, thiamazole.
case_images: fpsyt-14-1219049-g003.jpg
case_images: PMC10366534_01_fpsyt-14-1219049-g003.jpg
case_images: fig3
case_images: During phase A, for managing thyrotoxicosis, the patient received treatment with 8 mg of dexamethasone, 200 mg of potassium iodide, 2 mg of bisoprolol fumarate, and 30 mg of methimazole, while her psychotic symptoms were treated with a 40 mg/day blonanserin transdermal patch (details are shown in Figures 2, 3). The treatment course is shown in Figures 2, 3.