Case 45231

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Abstract
Presentation of CaseA forty-five-year-old housewife entered the hospital because of mental confusion.Seven years previously she came to the Out-Patient Department because of an increase in anxiety associated with domestic difficulties, and complained of choking sensations and palpitation. Physical examination at that time showed a tremulous, obese woman with a dusky cyanosis. The thyroid gland was palpable, but not enlarged. The hematocrit was 62 per cent, the basal metabolic rate was +16 per cent, and the urinary 17-ketosteroid excretion was normal. X-ray films of the chest (Fig. 1) and skull were essentially normal. Subsequently, she remained nervous, with numerous . . .

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