Intractable Pruritus as the Presenting Complaint in a Patient With Graves' Disease

• Published in: Endocrine practice Vol. 9; p. 2
• Main Authors: Teves, Denise, Chase, Lewis R
• Format: Journal Article
• Language: English
• Published: Jacksonville Elsevier Limited 01.03.2003
• ISSN: 1530-891X; 1934-2403

The objective of this study was to describe intractable pruritus as the initial complaint in a patient with hyperthyroidism. Researchers report a case of pruritus as the chief complaint in hyperthyroidism and review the related literature. A 44-year-old woman was referred by the Department of Dermatology because of persistent pruritus unrelieved by antihistaminic agents. She additionally noted heat intolerance, increased perspiration, fatigue, hyperdefecation, and weight loss for 8 months. The patient had enlargement of the right thyroid lobe and hyperreflexia. Aside from excoriations, the skin was unremarkable. She did not have exophthalmos, lid lag, or tremor. Thyrotropin was <0.01 μIU/mL, total thyroxine was 20.9 μg/dL, and triiodothyronine was 410 ng/dL. ^sup 123^I uptake was 75% at 24 hours. She received 8.5 mCi of ^sup 131^I and had total clinical improvement within 3 weeks after treatment. Pruritus can be the initial symptom of hyperthyroidism and disappears after successful treatment. Hyperthyroidism should be included in the differential diagnosis of chronic recalcitrant pruritus.