CASE ANALYSIS 2
•
1. A 41 YR OLD WOMAN
COMPLAINED OF INCREASED SWEATING OVER THE PREVIOUS 3 MONTHS. SHE ALSO STATED THAT SHE ALWAYS SEEMED
NERVOUS AND HAD HEART PALPITATIONS AND HEAT INTOLERANCE. SHE LOST 12 POUNDS OVER THE PAST 3 WEEKS AND
HAD NONCRAMPING DIARRHEA. ON
EXAMINATION, HER SKIN WAS WARM AND MOIST, SHE HAD A PROMINENT STARE, AND SHE
HAD TACHYCARDIA AT 140 BEATS PER MINUTE.
HER THYROID GLAND WAS DIFFUSELY ENLARGED WITH A SUGGESTION OF
NODULARITY.
LABORATORY FINDINGS
•
TT4 = 21.2 ug/dL ( 273
nmol/L)
•
THBR RATIO = 2.0
•
s-TSH = NONE DETECTED
•
FT4I = 42.4 ng/dL ( 546
pmol/L)
QUESTIONS
•
1. WHAT IS THE MOST
PROBABLE CAUSE OF THESE SYMPTOMS AND LABORATORY RESULTS?
•
2. WHAT ADDITIONAL LABORATORY TESTING WOULD BE
HELPFUL IN CONFIRMING THE DIAGNOSIS?
•
3. WHAT IS THE SIGNIFICANCE OF THE s- TSH TEST?
•
4. WHAT CAUSES THE DISORDER?
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