{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:42:59Z","timestamp":1791430979677,"version":"4.3.3"},"reference-count":11,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,4,3]]},"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:p>Thyrotoxicosis factitia, a disorder frequently seen in young or middle-aged women with psychological disorders, most commonly results from surreptitious ingestion of excess thyroid hormones. In most patients, diagnosis is relatively straightforward and depends on the demonstration of biochemical thyrotoxicosis, suppressed endogenous thyroid function and absence of clinical features of underlying thyroid disease. However, at times, confounding factors can make the diagnosis particularly challenging and necessitate the investigating physician to don the detective\u2019s cap to get to the root of the problem. We discuss a patient whose diagnosis was reached with ingenuity after considerable effort from four endocrinologists having a total experience of 37 years in their field.<\/jats:p>","DOI":"10.1136\/bcr-2018-226087","type":"journal-article","created":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T08:48:54Z","timestamp":1556527734000},"page":"e226087","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Thyroid detectives: on the trail of Munchausen\u2019s syndrome"],"prefix":"10.1136","volume":"12","author":[{"given":"Partha Pratim","family":"Chakraborty","sequence":"first","affiliation":[{"name":"Endocrinology and Metabolism, Medical College, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumik","family":"Goswami","sequence":"additional","affiliation":[{"name":"Endocrinology, Nil Ratan Sircar Medical College, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhankar","family":"Chowdhury","sequence":"additional","affiliation":[{"name":"Endocrinology and Metabolism, IPGME&R and SSKM Hospital, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,4,29]]},"reference":[{"key":"2025082804323453000_12.4.e226087.1","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.2147\/TCRM.S4110","article-title":"A thyrotoxicosis outbreak due to dietary pills in Paris","volume":"4","author":"Ioos","year":"2008","journal-title":"Ther Clin Risk Manag"},{"key":"2025082804323453000_12.4.e226087.2","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1007\/BF03350892","article-title":"The age of patients with thyrotoxicosis factitia in Italy from 1973 to 1996","volume":"22","author":"Bogazzi","year":"1999","journal-title":"J Endocrinol Invest"},{"key":"2025082804323453000_12.4.e226087.3","doi-asserted-by":"crossref","unstructured":"Salvatore D , Davies TF , Schlumberger MJ . et al Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. 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Philadelphia: Lippincott Williams & Wilkins, 2013:356\u201369."},{"key":"2025082804323453000_12.4.e226087.6","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1056\/NEJM198208123070705","article-title":"Low serum thyroglobulin as a clue to the diagnosis of thyrotoxicosis factitia","volume":"307","author":"Mariotti","year":"1982","journal-title":"N Engl J Med"},{"key":"2025082804323453000_12.4.e226087.7","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2011.011248"},{"key":"2025082804323453000_12.4.e226087.8","doi-asserted-by":"publisher","DOI":"10.1258\/acb.2007.007163"},{"key":"2025082804323453000_12.4.e226087.9","doi-asserted-by":"publisher","DOI":"10.1089\/105072503322240013"},{"key":"2025082804323453000_12.4.e226087.10","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.2169\/internalmedicine.52.0786","article-title":"False-positive radioiodine uptake in a functional ovarian cyst in a patient treated with total thyroidectomy for papillary cancer","volume":"52","author":"Jang","year":"2013","journal-title":"Intern Med"},{"key":"2025082804323453000_12.4.e226087.11","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1089\/thy.1993.3.101","article-title":"The measurement of fecal thyroxine in the diagnosis of thyrotoxicosis factitia","volume":"3","author":"Bouillon","year":"1993","journal-title":"Thyroid"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:32:45Z","timestamp":1756380765000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,4,29]]},"published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1136\/bcr-2018-226087"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226087","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4]]}}}