Classic symptoms are those of hyperthyroidism includes palpitation, anxiety, hand tremors, weight loss, pretibial myxedema and exophthalmos (fibroblasts in the orbital tissues may express the TSH receptor which causes accumulation of glycosaminoglycan behind the eyeball).
Continuous stimulation of TSH receptors by anti-thyroglobulin antibodies will release a high amount of T4 and T3 in circulation. The high level of thyroid hormones will decrease TRH and TSH production by negative feedback on the hypothalamus.
Ventricular fibrillation is the most common cause of death in Grave’s disease.
The patient is treated with propranolol and methimazole or propylthiouracil.
De quervain’s subacute thyroiditis is a self-limiting disease that usually occurs after a viral infection. It can manifest clinically with symptoms of hyperthyroidism and hypothyroidism.
Hyperthyroidism occurs due to the destruction of thyroid cells, which releases thyroid hormone into the bloodstream. Once cells get destroyed, the phase of hypothyroidism begins.
The thyroid gland is tender and painful on palpation.
On lab findings, ESR is classically elevated.
The patient is treated symptomatically with beta-blockers and NSAIDs. Propylthiouracil and methimazole are not indicated.
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