VOMITING AS THE CHIEF COMPLAINT - A 12 YE AR-OLD BOY WITH AN UNUSUAL PRESENTATION OF HYPERTHYROIDISM

A twelve year old boy presented with a sudden onset of recurrent nause a and vomiting. During the past six weeks he had a weight loss of 13 k g. While he was in the hospital, persistent tachycardia and a slightly elevated blood pressure were noted. The gastroenterologic, cardiologi c and neuropediatric examinations were normal. To exclude the differen tial diagnosis of hyperthyroidism, thyroid hormones were checked. They showed clearly elevated levels of triiodthyronine and thyroxine, whil e thyrotropin was suppressed. The boy did not have a goiter. Under thy reostatic therapy his clinical condition improved quickly. Among our 2 0 patients with hyperthyroidism he was the only one whose main symptom was severe vomiting.