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26th April 2024
A 34-year-old woman presents with a 3-month history of palpitations, tremors, heat intolerance, and unintentional weight loss despite an increased appetite.
A 34-year-old woman presents with a 3-month history of palpitations, tremors, heat intolerance, and unintentional weight loss despite an increased appetite. She also reports feeling more anxious and experiencing frequent bowel movements. On examination, she has a diffusely enlarged thyroid gland without nodularity. Her heart rate is 102 bpm, and she has a fine tremor in her hands. Her skin is warm and moist.
Investigations:
Serum TSH: <0.01 mU/L (0.4–4.0)
Free T4: 35 pmol/L (12–22)
Thyroid peroxidase antibodies (TPO): Negative
Thyroid-stimulating immunoglobulin (TSI): Positive
Erythrocyte sedimentation rate (ESR): Normal
Which is the most likely cause of her presentation?
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