Aggressive Behavior and Fire-Setting in a 4-Year-Old Boy Associated with Ingestion of Ground Beef Contaminated with Bovine Thyroid Tissue: A Case Report and Review of Neuropsychiatrie Findings in Pediatric Thyrotoxicosis

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Abstract
An epidemic of thyrotoxicosis in 1984—1985 was traced to the ingestion of ground beef that was contaminated by bovine thyroid tissue in the tri-state area of Minnesota, South Dakota, and Iowa. This article describes a case of possible thyrotoxicosis-induced violent aggressiveness and firesetting in a 4-year-old boy affected by this epidemic. Although psychosocial factors were initially considered primary, dietary factors eventually proven to be etiologic. This child showed spontaneous decreases in violent behavior during two admissions to a hospital (where thyroid-laced beef was not available) and recurrences with returning home (where he ate contaminated ground beef). A literature review on neuropsychiatrie manifestations of pediatric thyrotoxicosis revealed that thyrotoxicosis in children may present with subtle symptoms (new onset of ADHD, drop in school grades) or overt neuropsychiatric disorders (anxiety, mood, cognitive or psychotic disorders). However, the literature did not appear to have revealed previous reports of violent aggressiveness or firesetting in children. Our case suggests that thyrotoxicosis is able to induce or exacerbate behavioral deterioration, including marked aggressivity, in susceptible children. Clinicians should watch for thyrotoxicosis, which may occur without thyroid disease for a variety of reasons. Delayed treatment can result in enduring physical, cognitive, and emotional disturbances.

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