In the early summer of this year, I received a patient with ulcerative colitis (ulcerative node for short) in my outpatient clinic. He had been hospitalized in a hospital for one month for ulcerative nodules, but his symptoms did not resolve and he sought Chinese medicine treatment. The patient was hospitalized with “recurrent diarrhea for more than 3 years, aggravated with blood in stool for 20 days” and was given oral antibiotics, mesalazine enteric-coated tablets, prednisone and bifidobacterium triplex capsules, etc. After 14 days of treatment, the patient was discharged in remission. In 2012, the patient began to have symptoms of panic, hand tremors and excessive sweating, and consulted with the physician of the hospital, who did not pay much attention to the patient on the grounds of oral prednisone. In May 2014, the patient was admitted to the same hospital due to diarrhea more than 10 times a day with pus and blood in the stool. During hospitalization, the patient applied antibiotics, mesalazine extended-release granules, methylprednisolone, azathioprine and other drugs, and repeatedly complained to the physician about the uncomfortable symptoms such as panic, hand trembling and excessive sweating, and the physician still thought that long-term oral hormone administration was the cause. The patient’s condition did not improve after 28 days of hospitalization, so he came to our hospital and asked to take The patient was hospitalized for 28 days without any improvement, so he came to our hospital and asked for Chinese medicine treatment. When the patient described his condition, I saw that his expression was hyperactive, his face was red, his arms were sweaty when I touched them, and his pulse was fast. I asked the patient to take blood for thyroid function on an empty stomach the next day. The test results showed: serum total T3 5.66nmolT3/L↑ (reference value 1.31-3.0nmolT3/L), serum total T4 258.90nmolT4/L↑ (reference value 59-154nmolT4/L), serum free T3 24.68pmol/L↑ (reference value 4.6-6.4pmol/L), serum free T4 89.51pmol/L↑ (reference value 12.0-22.0pmol/L), serum thyroid stimulating hormone 0.005mIU/L↓ (reference value 0.27-4.2mIU/L), from these laboratory results, the patient had hyperthyroidism (referred to as hyperthyroidism). The patient was admitted to our endocrinology department and was given a combination of medication for ulcers and hyperthyroidism. After 5 days, the patient’s symptoms such as diarrhea, panic, hand tremors and excessive sweating were significantly relieved; after 14 days, the symptoms disappeared and he was discharged. Recently, I followed up with the patient by phone. He is still taking the medication for ulcers and hyperthyroidism, and he has no pus and blood in his stool 3 times a day, and no other discomfort. Studies have shown that hyperthyroidism can exacerbate intestinal symptoms in patients with ulcers and affect the effectiveness of treatment for ulcers. The symptoms of ulcerative nodules and hyperthyroidism are similar in many ways, such as frequent stools, which can easily mask each other and lead to missed diagnosis. The case in the article is a reminder that when a patient with ulcerative nodes presents with hypermetabolic signs, it is important to consider whether the patient has hyperthyroidism in combination in order to avoid a missed diagnosis or misdiagnosis.