INTRODUCTION: @entity1375 is one of the most important causes of treatable @entity303 , and @entity716 occasionally associated with it is known as @entity3568 . We report a case of a 90-year-old @entity1 who developed @entity3568 acutely without overt clinical symptoms and signs suggestive of @entity1375 . CASE PRESENTATION: A 90-year-old Japanese @entity1 , a general practitioner, was admitted to our emergency room because of acute-onset lethargy, delusions, and @entity1833 . He had been actively working until 3  days before the admission. Upon admission, his general physical examination was unremarkable. However, a blood investigation showed the presence of @entity1375 , and computed tomography revealed @entity1143 and @entity843 . Electroencephalography revealed diffuse slow waves with a decrease of a-wave activity. A single-photon emission computed tomography scan revealed a decrease of cerebral blood flow in both frontal lobes. The @entity1 was soon treated with @entity6145 replacement therapy. Following normalization of his thyroid function, both @entity1143 and @entity843 diminished and his electroencephalographic activity improved simultaneously; however, he did not recover from his @entity716 . CONCLUSIONS: @entity3568 madness should be kept in mind in the differential diagnosis of acute @entity716 in elderly @entity1 , particularly the oldest @entity1 as in our case, because manifestations of @entity1375 often may be indistinguishable from the aging process.

Acute @entity716 as an initial manifestation of XXXX : a case report.

@entity1 :: ('9606', 'Species') :: ['patient', 'patients', 'man'] @entity1375 :: ('MESH:D007037', 'Disease') :: ['Hypothyroidism', 'hypothyroidism'] @entity1143 :: ('MESH:D010996', 'Disease') :: ['pleural effusion'] @entity303 :: ('MESH:D003704', 'Disease') :: ['dementia'] @entity843 :: ('MESH:D001201', 'Disease') :: ['ascites'] @entity1833 :: ('MESH:D006212', 'Disease') :: ['hallucinations'] @entity716 :: ('MESH:D011605', 'Disease') :: ['psychosis'] @entity3568 :: ('MESH:D009230', 'Disease') :: ['myxedema madness', 'Myxedema'] @entity6145 :: ('CHEBI:60311', 'Chemical') :: ['thyroid hormone']
@entity1375 :: (MESH:D007037,Disease) :: ['hypothyroidism']
