A 23-year-old woman presents with sweating and tremor. Her thyroid function tests are as follows:
- TSH <0.05 mU/l
- Free T4 25 pmol/l
What is the most common cause of this presentation?
A. Hashimoto's thyroiditis
B. Graves' disease
C. Toxic nodular goitre
D. De Quervain's thyroiditis
E. Toxic adenoma
Answer:
B. Graves' disease
Discussion:
Thyrotoxicosis
Graves' disease accounts for around 50-60% of cases of thyrotoxicosis.
Causes
Graves' disease
toxic nodular goitre
subacute (de Quervain's) thyroiditis
post-partum thyroiditis
acute phase of Hashimoto's thyroiditis (later results in hypothyroidism)
toxic adenoma (Plummer's disease)
amiodarone therapy
Investigation
TSH dcreased, T4 and T3 increased
thyroid autoantibodies
other investigations are not routinely done but includes isotope scanning
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