Thyrotoxicosis Elderly presentation

THYROTOXICOSIS IN OLD AGE: A DIFFERENT CLINICAL ENTITY

A BHATTACHARYYA, PHILIP G WILES.

Hospital Medicine 1999;60:115-8

Thyrotoxicosis generally presents with classic signs and symptoms in younger people. Among the elderly population atypical presentation is recognized, although this has not been well quantified or characterized. To avoid misdiagnosis or delay in diagnosis, clinical suspicion needs to remain high.

Thyrotoxicosis, a condition producing a raised level of circulating thyroid hormones, is accompanied by a broad array of symptoms and signs, which can differ markedly among individuals. It is often stated, and is the authors impression, that the clinical features of thyrotoxicosis may be significantly altered in elderly people, so that symptoms and physical findings typical in young persons may be modified, different or absent in this age group. There are, however, few published data.

The diagnosis of thyroid disorders may be further complicated by the normal ageing-associated changes in thyroid physiology. The situation is often compounded by the impact of non-thyroidal illnesses, which frequently accompany older people, influencing diagnosis and management. To try and characterized these differences, we reviewed 36 cases of thyrotoxicosis among elderly patients seen in our endocrinology clinic.