J Neurogastroenterol Motil.  2010 Oct;16(4):428-432.

Thyrotoxic Vomiting: A Case Report and Possible Mechanisms

• Shim S
• Ryu HS
• Oh HJ
• Kim YS

Abstract

The symptoms related to gastrointestinal (GI) tract are sometimes chief complaints in patients with endocrine disease. Thyrotoxicosis is a rare, but notable cause for unexplained and repeated vomiting. Here, we report an adolescent patient with thyrotoxicosis who was initially presented with repeated vomiting and epigastric pain. A 13-year-old female was referred to a GI outpatient department for evaluation of vomiting and abdominal pain from a pediatric clinic. Esophagogastroduodenoscopy revealed acute gastritis with duodenogastric reflux and suspicious reflux esophagitis of minimal change, but there was no significant improvement after treatment and as a result she was admitted to the emergency room. She was subsequently diagnosed as Graves' disease because an initial laboratory test at the GI outpatient department revealed thyroid stimulating hormone < 0.01 microIU/mL and additional blood tests showed elevated thyroid hormones and positive thyroid stimulating hormone receptor antibody. The vomiting and epigastric pain improved remarkably after treatment with antithyroid drugs. Clinicians should consider the possibility of thyrotoxicosis in patient with unexplained and repeated vomiting.

Keyword

Adolescent; Thyrotoxicosis; Vomiting

MeSH Terms

Abdominal Pain
Adolescent
Antithyroid Agents
Duodenogastric Reflux
Emergencies
Endocrine System Diseases
Endoscopy, Digestive System
Esophagitis, Peptic
Female
Gastritis
Graves Disease
Hematologic Tests
Humans
Outpatients
Receptors, Thyrotropin
Thyroid Hormones
Thyrotoxicosis
Thyrotropin
Vomiting
Antithyroid Agents
Receptors, Thyrotropin
Thyroid Hormones
Thyrotropin