MAURICE BRUGER, M.D., F.A.C.P.; VINCENT P. HOLLANDER, M.D., Ph.D.
The problem presented by patients with elevated basal metabolic rates in whom careful study precludes a diagnosis of hyperthyroidism is exceedingly complex. Since the basal metabolism as measured is the sum of the rates of oxygen consumption of all the cells of the body (which number about 40 quintillion), and these in turn are controlled by physical, humoral, endocrine, pharmacologic and vegetative as well as central neural factors, the complexity is expected and understandable. Table 1 illustrates the many clinical, physiologic and physical factors the clinician must keep in mind when confronted with this problem.
BRUGER M, HOLLANDER VP. EXTRATHYROIDAL HYPERMETABOLISM: CLASSIFICATION AND DISCUSSION INCLUDING THREE ILLUSTRATIVE CASE REPORTS1. Ann Intern Med. ;35:1260–1275. doi: 10.7326/0003-4819-35-6-1260
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Published: Ann Intern Med. 1951;35(6):1260-1275.
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