Graves disease

Case contributed by Ammar Ashraf
Diagnosis certain

Presentation

Neck swelling, weight loss, tremors and palpitation. No visual disturbance.

Patient Data

Age: 35 years
Gender: Male

Tc-99m thyroid scintigraphy

Nuclear medicine

Well-outlined enlarged thyroid gland showing homogeneously increased radiotracer accumulation. Thyroid uptake function: 13.2% (Normal:0.4-4%). Poor visualization of the salivary glands, likely secondary to the intense radiotracer uptake by the thyroid gland. 

Case Discussion

  • Free T4=39.06 pmol/L (reference range=9-19).
  • TSH=<00.01 mIU/L (reference range=0.35-4.94).
  • TSH receptor antibodies=2.9+ IU/l (reference range= <1.8).
  • The above mentioned clinical history, laboratory & scan findings are suggestive of diffuse goiter with significantly elevated thyroid uptake function secondary to the Graves disease.

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