Transcription of Update on the Diagnosis and Treatment of Hyperthyroidism
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Update on the Diagnosis and Treatment of Hyperthyroidism
298 JCOM June 2008 Vol. 15, No. 6 stUdyinitial presentationA 25-year-old woman presents to her physician with symptoms of fatigue, headaches, and fluctuat-ing weight. On examination, vital signs are within normal range. Body mass index (BMI) is 28 kg/m2. Thyroid examina-tion is unremarkable. A thyroid-stimulating hormone (TSH) level is ordered and found to be low at mIU/L (reference range, mIU/L). Free levorotatory thyroxine (T4) and free triiodothyronine (T3) levels are subsequently checked and found to be normal. How should the results of the patient s thyroid function tests be interpreted? A patient with low TSH and normal T4 and T3 is consid-ered to have subclinical Hyperthyroidism . Typically, these patients do not have clear signs and symptoms of hyper-thyroidism. The prevalence of subclinical Hyperthyroidism ranges from to This variability is partly due to differences among studies in the definition of a low serum TSH value [1 4].
www.turner-white.com Vol. 15, No. 6 June 2008 JCOM 299 CAse-BAsed revieW • What is the clinical significance of subclinical hyper-thyroidism? The cardiovascular system and the skeletal system are the
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