Hashimoto's thyroiditis (HT) is an autoimmune thyroiditis that occurs frequently in middle-aged women. To date, there is no formally reported association between acute mania and hypothyroidism due to HT. We report a case of acute mania associated with hypothyroidism resulting from HT. Our patient's mania and hypothyroidism remitted gradually after the treatment with mood stabilizer/antipsychotic drugs and levothyroxine therapy. This case highlights the importance of ascertaining thyroid function and checking antithyroid antibodies in middle-aged female patients with affective symptoms to the hospital for the first time.

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