Analysis of Misdiagnosis of Subclinical Hypothyroidism

GAO Mingxiu; FU Huabin; LI Xiujing; QI Ge; ZHAO Huidong

doi:10.3969/j.issn.1002-3429.2024.02.006

Abstract：Objective To explore the causes of misdiagnosis of subclinical hypothyroidism(SCH)and to improve understanding of this disease.Methods The clinical data of 4 cases with SCH misdiagnosed from September 2021 to Septem-ber 2023 were retrospectively analyzed.Results Among the 4 cases,1 case was misdiagnosed as autonomic nervous disorder and chronic gastritis due to repeated nervousness,upset,abdominal distension,poor appetite for half a year,which were ag-gravated with weight loss for 1 month.One patient was misdiagnosed with anxiety and depression due to emotional instability,irritability,memory loss,decreased self-evaluation,and poor sleep for 2 years.One case was misdiagnosed as climacterium syndrome due to persistent nervousness,chest distress,dizziness,loss of appetite for six months,which were aggravated with fatigue for half a month.One patient was misdiagnosed as anemia and hyperlipidemia due to upset,chest tightness,low mood,decreased physical strength and poor sleep for 1 year,which were aggravated for 2 weeks.The misdiagnosis lasted six months to two years.Patients did not respond well to the corresponding treatment,and upon the diagnostic test of thyroid function,it was confirmed as SCH.After diagnosis,4 cases were given targeted treatment such as Levothyroxine for 2 months to 6 months,all of which had good effect and achieved clinical cure.Conclusion SCH is a common endocrine disease in clinic practice,which is the early stage of hypothyroidism,with high incidence rate,hidden onset,various and atypical clinical symptoms,and likelihood to miss diagnosis and misdiagnosis.Clinicians should improve their understanding of the disease,and timely relevant examinations and specialist consultation may help reduce or avoid misdiagnosis and mistreatment.