{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T15:35:57Z","timestamp":1759937757703,"version":"3.44.0"},"reference-count":6,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,2,19]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>A 26-year-old cachectic man presented with an altered mental status. He was agitated, tremulous, hyperthermic and diaphoretic with largely dilated pupils. Collateral history revealed acute ingestion of 3,4-methylenedioxymethamphetamine on a background of chronic drug abuse. His condition deteriorated requiring sedation and intubation with transfer to the intensive care unit. A diagnosis of serotonin syndrome was made, based on his findings in keeping with the Hunter criteria, and he was treated with supportive management during a resultant and briefly sustained delirium. With gradual resolution of his agitated state, further questioning and blood work a concurrent, and potentially contributory, thyrotoxicosis was revealed. The patient was commenced on treatment for this with urgent outpatient follow-up with both a local otolaryngologist and endocrinologist for consideration of further treatment.<\/jats:p>","DOI":"10.1136\/bcr-2018-228404","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T05:17:16Z","timestamp":1552022236000},"page":"e228404","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Serotonin syndrome unmasking thyrotoxicosis"],"prefix":"10.1136","volume":"12","author":[{"given":"Geoffrey Peter","family":"Ronan","sequence":"first","affiliation":[{"name":"Renal\/General Medicine, Mercy University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Ronan","sequence":"additional","affiliation":[{"name":"University College Cork, National University of Ireland, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siobhan","family":"McGettigan","sequence":"additional","affiliation":[{"name":"University College Cork, National University of Ireland, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemma","family":"Browne","sequence":"additional","affiliation":[{"name":"Renal\/General Medicine, Mercy University Hospital, Cork, Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,3,7]]},"reference":[{"key":"2025082804315793000_12.3.e228404.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra041867"},{"key":"2025082804315793000_12.3.e228404.2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-200007000-00001"},{"key":"2025082804315793000_12.3.e228404.3","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcg109"},{"key":"2025082804315793000_12.3.e228404.4","unstructured":"The Endocrine Society\u2019s 95th Annual Meeting. In: Kelley CE , Lien LF , Perkins JM , A diagnostic dilemma of abnormal thyroid labs concerning for hyperthyroidism in a patient with serotonin syndrome: The Endocrine Society\u2019s 95th Annual Meeting, 2013. SAT-451."},{"key":"2025082804315793000_12.3.e228404.5","doi-asserted-by":"publisher","DOI":"10.1038\/sj.mp.4000963"},{"key":"2025082804315793000_12.3.e228404.6","doi-asserted-by":"publisher","DOI":"10.1530\/acta.0.1260315"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228404","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T11:32:04Z","timestamp":1756380724000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228404"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":6,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,7]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bcr-2018-228404"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228404","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}