<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2182-5173</journal-id>
<journal-title><![CDATA[Revista Portuguesa de Medicina Geral e Familiar]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Port Med Geral Fam]]></abbrev-journal-title>
<issn>2182-5173</issn>
<publisher>
<publisher-name><![CDATA[Associação Portuguesa de Medicina Geral e Familiar]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2182-51732021000400357</article-id>
<article-id pub-id-type="doi">10.32385/rpmgf.v37i4.13016</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Hipertiroidismo agudo: um possível caso de síndroma de Marine Lenhart]]></article-title>
<article-title xml:lang="en"><![CDATA[Acute hyperthyroidism: a likely marine lenhart syndrome&#8217;s case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moreira]]></surname>
<given-names><![CDATA[Valter Filipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ribeiro]]></surname>
<given-names><![CDATA[Andreia Teles]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidade de Lisboa Faculdade de Medicina ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,ACeS Lisboa Ocidental e Oeiras USF Descobertas ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>09</month>
<year>2021</year>
</pub-date>
<volume>37</volume>
<numero>4</numero>
<fpage>357</fpage>
<lpage>361</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2182-51732021000400357&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2182-51732021000400357&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2182-51732021000400357&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  O hipertiroidismo (HT) é uma patologia que ocorre devido à síntese e secreção excessiva de hormonas tiroideias pela glândula tiroideia, estimando-se que a sua prevalência a nível mundial se situa entre 1,2 e 1,6%. A principal etiologia do HT é a doença de Graves (DG), seguida do bócio multinodular (BMN) tóxico. As manifestações clínicas do HT podem variar, desde o quadro assintomático até ao quadro de tempestade tiroideia, uma situação rara de tirotoxicose aguda grave e potencialmente fatal. O síndroma de Marine Lenhart (SML) consiste num quadro de HT em contexto de coexistência de DG e BMN tóxico, sendo uma situação rara que ocorre em 0,8 a 2,7% dos pacientes com DG.  Descrição do caso:  Mulher de 50 anos, com antecedentes pessoais de BMN tóxico não medicado, recorre a consulta de doença aguda por quadro caracterizado por fraqueza extrema com impotência funcional para a marcha, insónia grave, labilidade emocional e irritabilidade associada a palpitações. Foi referenciada ao serviço de urgência (SU) onde foi diagnosticada com HT grave por DG, tendo ficado internada. Houve estabilização clínica e laboratorial com melhoria dos sintomas e teve alta com o provável diagnóstico de SML.  Comentário:  Este caso demonstra a importância da monitorização tiroideia e vigilância sintomática dos doentes com patologia tiroideia de base. O médico de família tem um papel fundamental no controlo destas situações por ter um acompanhamento longitudinal dos seus pacientes. Uma abordagem mais abrangente de cada doente e a articulação entre os cuidados de saúde primários e secundários permite a identificação de problemas clínicos específicos e tratamento precoce dos mesmos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Hyperthyroidism (HT) is a pathology that occurs due to the synthesis and excessive secretion of thyroid hormones by the thyroid gland and its prevalence worldwide is between 1.2 to 1.6%. The main etiology of HT is Graves&#8217; disease (GD), followed by toxic multinodular goiter (MNG). The clinical manifestations of HT can vary from asymptomatic to a thyroid storm, a rare situation of severe acute and potentially fatal thyrotoxicosis. Marine Lenhart syndrome (MLS) consists of an HT that coexists with a toxic MNG and GD. It is a rare situation that occurs in 0.8 to 2.7% of patients with GD.  Case description:  A 50-year-old woman, with a personal history of unmedicated toxic, MNG, goes to an appointment due to an extreme weakness with functional impotence for walking, severe insomnia, emotional lability, and irritability associated with palpitations. She was referred to the emergency department where she was diagnosed with severe HT due to GD, having been hospitalized. There was clinical and laboratory stabilization with an improvement of symptoms, and she was discharged from the hospital with the probable diagnosis of MLS.  Comments:  This case demonstrates the importance of thyroid monitoring and supervision of symptoms in patients with thyroid disease. The family doctor has a fundamental role in controlling these situations because of the longitudinal monitoring of their patients. A broader approach to each patient and the link between primary and secondary health care allow the identification of specific clinical problems and their early treatment.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Hipertiroidismo]]></kwd>
<kwd lng="pt"><![CDATA[Tirotoxicose]]></kwd>
<kwd lng="pt"><![CDATA[Doença de Graves]]></kwd>
<kwd lng="en"><![CDATA[Hyperthyroidism]]></kwd>
<kwd lng="en"><![CDATA[Thyrotoxicosis]]></kwd>
<kwd lng="en"><![CDATA[Graves&#8217; disease]]></kwd>
</kwd-group>
</article-meta>
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