<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0026-1742</journal-id>
<journal-title><![CDATA[Revista de la Facultad de Medicina (México)]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Fac. Med. (Méx.)]]></abbrev-journal-title>
<issn>0026-1742</issn>
<publisher>
<publisher-name><![CDATA[Universidad Nacional Autónoma de México, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0026-17422016000300022</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Hipertiroidismo apático en paciente de mediana edad. Reporte de caso y revisión de la literatura]]></article-title>
<article-title xml:lang="en"><![CDATA[Apathetic hyperthyroidism in middle-aged patient. Case report and literature review]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Briseño López]]></surname>
<given-names><![CDATA[Pedro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ceballos Villalva]]></surname>
<given-names><![CDATA[Jesús Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rodríguez Cázares]]></surname>
<given-names><![CDATA[Zuleika Miroslawa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Téllez Manríquez]]></surname>
<given-names><![CDATA[Luis Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Mendoza Zubieta]]></surname>
<given-names><![CDATA[Victoria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[MacGregor Gooch]]></surname>
<given-names><![CDATA[Julián Malcolm]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,UNAM Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI Hospital de Especialidades]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI Hospital de Especialidades]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2016</year>
</pub-date>
<volume>59</volume>
<numero>3</numero>
<fpage>22</fpage>
<lpage>26</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0026-17422016000300022&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0026-17422016000300022&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0026-17422016000300022&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El hipertiroidismo es una patología frecuente que suele ser fácilmente reconocida por sus síntomas y signos. El hipertiroidismo apático es una forma de presentación de hipertiroidismo sin signos y síntomas característicos. Los síntomas cardinales del hipertiroidismo apático son la depresión y apatía; por ello, la ausencia de síntomas y signos clásicos retrasa el diagnóstico y el tratamiento, pues a menudo se diagnostica erróneamente como un trastorno psiquiátrico primario. Es más frecuente en pacientes de edad avanzada y es extremadamente rara en niños y adultos de mediana edad. Reportamos el caso de una mujer de mediana edad con hipertiroidismo apático caracterizado por depresión, vértigo, edema y pérdida de peso, sin otros datos clínicos de hipertiroidismo. Durante dos años recibió tratamiento por depresión, y adicionalmente fue estudiada en otras especialidades por vértigo. El diagnóstico se estableció mediante pruebas de función tiroidea y la integración con las características clínicas.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Hyperthyroidism is a common condition that is easily recognized by its signs and symptoms. The apathetic hyperthyroidism is a form of presentation of hyperthyroidism without its characteristic signs and symptoms. The cardinal symptoms of apathetic hyperthyroidism are depression and apathy. The absence of classical signs and symptoms of hyperthyroidism delays the diagnosis and treatment of the disease, as it is often misdiagnosed as a primary psychiatric disorder. It is more common in elderly patients and is extremely rare in children and middle-age adults. We report the case of a middle-age woman with apathetic hyperthyroidism characterized by depression, dizziness, edema and weight loss without other clinical data of hyperthyroidism; she had been treated for two years for major depressive disorder. She had been studied by other specialties because of vertigo. The diagnosis was made after thyroid function tests were requested, and joined with clinical findings.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Pérdida de peso]]></kwd>
<kwd lng="es"><![CDATA[vértigo]]></kwd>
<kwd lng="es"><![CDATA[depresión]]></kwd>
<kwd lng="es"><![CDATA[hipertiroidismo apático]]></kwd>
<kwd lng="en"><![CDATA[Weight loss]]></kwd>
<kwd lng="en"><![CDATA[vertigo]]></kwd>
<kwd lng="en"><![CDATA[depression]]></kwd>
<kwd lng="en"><![CDATA[apathetic hyperthyroidism]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mandel]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Larsen]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
<name>
<surname><![CDATA[Davies]]></surname>
<given-names><![CDATA[TF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Thyrotoxicosis]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Melmed]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Polonsky]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Larsen]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
<name>
<surname><![CDATA[Kronenberg]]></surname>
<given-names><![CDATA[HM]]></given-names>
</name>
</person-group>
<source><![CDATA[Williams Textbook of Endocrinology]]></source>
<year>2011</year>
<edition>12</edition>
<publisher-loc><![CDATA[Philadelphia ]]></publisher-loc>
<publisher-name><![CDATA[Elsevier Saunders]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lahey]]></surname>
<given-names><![CDATA[FH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apathetic thyroidism]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>1931</year>
<volume>93</volume>
<page-range>1026-30</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Trivalle]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Doucet]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Chassagne]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Landrin]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Kadri]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Menard]]></surname>
<given-names><![CDATA[JF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Differences in the signs and symptoms of hyperthyroidism in older and younger patients]]></article-title>
<source><![CDATA[J Am Geriatr Soc]]></source>
<year>1996</year>
<volume>44</volume>
<page-range>50-3</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Boelaert]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Torlinska]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Holder]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Franklyn]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Older subjects with hyperthyroidism present with a paucity of symptoms and signs a large cross-sectional study]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2010</year>
<volume>95</volume>
<page-range>2715-26</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[McGee]]></surname>
<given-names><![CDATA[RR]]></given-names>
</name>
<name>
<surname><![CDATA[Whittaker]]></surname>
<given-names><![CDATA[RL]]></given-names>
</name>
<name>
<surname><![CDATA[Tullis]]></surname>
<given-names><![CDATA[IF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apathetic thyroidism review of the literature and report of four cases]]></article-title>
<source><![CDATA[Ann Intern Med]]></source>
<year>1959</year>
<volume>50</volume>
<page-range>1418-32</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Teeluckshingh]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Pendek]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Padfield]]></surname>
<given-names><![CDATA[PL]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apathetic thyrotoxicosis in adolescence]]></article-title>
<source><![CDATA[J Intern Med]]></source>
<year>1991</year>
<volume>229</volume>
<page-range>543-4</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Grewal]]></surname>
<given-names><![CDATA[RP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apathetic hyperthyroidism in an adolescent]]></article-title>
<source><![CDATA[J Psychiatr Neurosci]]></source>
<year>1993</year>
<volume>18</volume>
<page-range>276</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wagle]]></surname>
<given-names><![CDATA[AC]]></given-names>
</name>
<name>
<surname><![CDATA[Wage]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[AG]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apathetic form of thyrotoxicosis]]></article-title>
<source><![CDATA[Can J Psychiatry]]></source>
<year>1998</year>
<volume>43</volume>
<page-range>747-8</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Sun]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Yu]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Meng]]></surname>
<given-names><![CDATA[Q]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Miao]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A clinical retrospective analysis of factor associated with apathetic hyperthyroidism]]></article-title>
<source><![CDATA[Pathobiology]]></source>
<year>2010</year>
<volume>77</volume>
<page-range>46-51</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Feroze]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[May]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apathetic thyrotoxicosis]]></article-title>
<source><![CDATA[Int J Clin Pract]]></source>
<year>1997</year>
<volume>51</volume>
<page-range>332-3</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Arnold]]></surname>
<given-names><![CDATA[BM]]></given-names>
</name>
<name>
<surname><![CDATA[Casal]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Higgins]]></surname>
<given-names><![CDATA[HP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apathetic thyrotoxicosis]]></article-title>
<source><![CDATA[CMAJ]]></source>
<year>1974</year>
<volume>111</volume>
<page-range>957-8</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Zefirova]]></surname>
<given-names><![CDATA[GS]]></given-names>
</name>
<name>
<surname><![CDATA[Lebedev]]></surname>
<given-names><![CDATA[VV]]></given-names>
</name>
<name>
<surname><![CDATA[Mirzoiants]]></surname>
<given-names><![CDATA[GG]]></given-names>
</name>
<name>
<surname><![CDATA[Strokov]]></surname>
<given-names><![CDATA[IA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Apathetic form of thyrotoxicosis]]></article-title>
<source><![CDATA[Ter Arkh]]></source>
<year>1986</year>
<volume>58</volume>
<page-range>112-4</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gaitonde]]></surname>
<given-names><![CDATA[DY]]></given-names>
</name>
<name>
<surname><![CDATA[Kepchar]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Sartori]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sarkar]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Painless thyroiditis presenting as apathetic hyperthyroidism in a young male]]></article-title>
<source><![CDATA[Mil Med]]></source>
<year>2008</year>
<volume>173</volume>
<page-range>609-11</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Weetman]]></surname>
<given-names><![CDATA[AP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Graves' disease]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2000</year>
<volume>343</volume>
<page-range>1236-48</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ross]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Radioiodine therapy for hyperthyroidism]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2011</year>
<volume>364</volume>
<page-range>542-50</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="book">
<collab>CENETEC</collab>
<source><![CDATA[Diagnóstico y Tratamiento de la Enfermedad de Graves en mayores de 18 años]]></source>
<year>2011</year>
<publisher-loc><![CDATA[México ]]></publisher-loc>
<publisher-name><![CDATA[Secretaría de Salud]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bahn]]></surname>
<given-names><![CDATA[RS]]></given-names>
</name>
<name>
<surname><![CDATA[Burch]]></surname>
<given-names><![CDATA[HB]]></given-names>
</name>
<name>
<surname><![CDATA[Cooper]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
<name>
<surname><![CDATA[Garber]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Greenlee]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Klein]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hyperthyroidism and other causes of thyrotoxicosis management guidelines of the American Thyroid Association and American Association of Clinical Endocrinologists]]></article-title>
<source><![CDATA[Thyroid]]></source>
<year>2011</year>
<volume>21</volume>
<page-range>593-646</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bartalena]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Tanda]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Graves' ophthalmopathy]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2009</year>
<volume>360</volume>
<page-range>994-1001</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cooper]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Antithyroid drugs]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2005</year>
<volume>352</volume>
<page-range>905-17</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
