Endocrine Exophthalmos during Lithium Therapy of Manic-Depressive Disease

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Abstract
WE have observed the development of measurable exophthalmos, either bilateral or unilateral, in some psychiatric patients on maintenance lithium therapy. This exophthalmos was clinically indistinguishable from endocrine exophthalmos. Our original aim was to identify, by serial evaluation of thyroid function, susceptible persons in whom hypothyroidism or a goiter (or both) might develop during the course of lithium therapy, as has been reported by other groups.1 2 3 Material and MethodsPatients with manic-depressive illness were referred to a psychiatric group for the institution of prophylactic lithium carbonate therapy. Pre-lithium thyroid evaluation consisted of a history, physical examination and determination of protein-bound iodine . . .

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