Case study: missed diagnosis and mistreatment of unrecognized comorbid Graves disease

• Published in: Journal of the American Academy of Child and Adolescent Psychiatry Vol. 38; no. 7; p. 861
• Main Authors: Woolston, J L, Caracansi, A
• Format: Journal Article
• Language: English
• Published: United States 01-07-1999
• Subjects: Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - drug therapy; Child; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - drug therapy; Diagnosis, Differential; Diagnostic Errors; Graves Disease - complications; Graves Disease - diagnosis; Graves Disease - drug therapy; Humans; Male; Polyendocrinopathies, Autoimmune - diagnosis; Polypharmacy; Tachycardia, Sinus; Tourette Syndrome - complications; Tourette Syndrome - drug therapy; Treatment Outcome
• ISSN: 0890-8567
• DOI: 10.1097/00004583-199907000-00016

Comorbid medical conditions are known to complicate the course and treatment of psychiatric disorders. This case study provides the first published report of Graves disease exacerbating the symptoms of Tourette's disorder and attention-deficit hyperactivity disorder (ADHD). The lack of diagnosis of the Graves disease compromised the efficacy of the treatment of Tourette's disorder and ADHD. This case study supports the need to the consider increased risk of a second immunoendocrinological disorder in the presence of diabetes mellitus type I, one of the several disorders that comprise the syndrome of polyglandular autoimmune endocrinopathy type II.