20th August 2020

A 27-year-old man is seen by his GP following 2 weeks of worsening sore throat, fever and difficulty swallowing

A 27-year-old man is seen by his GP following 2 weeks of worsening sore throat, fever and difficulty swallowing. He mentioned having a flu like illness in the family with his partner and youngest child being unwell for a few days the previous month. When asked about his eating and drinking, he says that he hasn’t had much appetite from the fever and sore throat but is still opening his bowels multiple times in the day. His GP arranged for some blood tests to confirm his suspected diagnosis. The blood results were as follows: T₄  200mmol/L, TSH 0.1 mu/L.

For the patient above, please select the SINGLE most likely diagnosis based on the clinical history and/or biochemical tests provided. Select ONE option from the list above. 

You may use the following reference ranges:

• Serum total thyroxine, T₄: 70 – 140 mmol/L
• Serum Thyroid stimulating hormone, TSH: 0.5 – 5.7mu/L
• Serum sodium, Na⁺: 135 – 145mmol/L
• Serum potassium, K⁺: 3.5 – 5.0 mmol/L
• Serum total calcium, Ca²⁺: 2.12 – 2.65 mmol/L
• Serum parathyroid hormone, PTH: 2 – 7 pmol/L
• Serum (fasting) glucose: 4 – 6 mmol/L