Case history
Case history
A 30-year-old woman presents with several months of gradually increasing heat intolerance and nervousness. She has lost 2 to 3 kg. There is no history of head and neck irradiation. She grew up in a mountainous area of Greece and recently immigrated to the US. Her grandmother had a goitre. Physical examination reveals a mildly anxious woman with pulse 90 bpm and BP 140/60 mmHg. There is a 4-cm mobile right-sided thyroid nodule without lymphadenopathy or bruit. She has mild stare and lid lag without exophthalmos; warm moist skin; and a slight tremor. Reflexes are brisk. The remainder of the examination is normal.
Other presentations
Occasionally, patients present with compressive symptoms (hoarseness, dysphagia or dyspnoea). Rarely, a patient presents with sudden thyroidal pain after haemorrhage into an autonomously functioning thyroid nodule, associated with transient thyrotoxicosis.[2]
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