25th August 2020

A 38-year-old lady with a history of systemic lupus erythematosus (SLE) presented to her GP with 7 months of cold intolerance, weight gain, lethargy and menorrhagia

A 38-year-old lady with a history of systemic lupus erythematosus (SLE) presented to her GP with 7 months of cold intolerance, weight gain, lethargy and menorrhagia. This was preceded by a 2 months period of heat intolerance, profuse sweating, oligomenorrhea and restlessness. She has had no previous surgery to the neck or thyroid. She has a balanced diet and drinks only socially. Physical examination revealed a raised BMI of 28 kg/m2, diffuse goitre, and non-pitting oedema. Observations are all within normal range including normal blood pressure and normal heart rate. 

Based on the clinical evidence above, what is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.