MASKED HYPERTHYROIDISM

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Abstract
The diagnosis of the usual case of exophthalmic goiter, toxic adenoma of the thyroid gland or hyperthyroidism, does not offer any particular difficulty. The presence of thyroid enlargement, tachycardia, tremor, exophthalmos, loss of weight, excessive perspiration, nervousness, insomnia, increased metabolic rate, fatigability or depression, singly or in association, leads one to diagnose, or at least suspect, the possibility of some form of thyroid disturbance. The atypical, obscure or masked cases of hyperthyroidism, however, are recognized with greater difficulty, are overlooked entirely, are misinterpreted as some other form of disease, or are classified as questionable hyperthyroidism with considerable misgivings. It is with a group of such cases, observed during the past three years in the course of routine ward and private practice, that the present paper is concerned. In recent years, similar instances of obscure or atypical thyroid disease have received increasing attention on the part of internists, surgeons, general practitioners,

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