Disease causes grave concern

Jane, a 34-year-old lawyer, presents following an 8kg weight loss over the past 12 weeks despite an increased appetite.

She has also noted increasing anxiety, difficulty concentrating and a hand tremor. She has been sweating more than usual, has found sleeping difficult and reports a racing heart.  Jane has had no similar episodes previously but has noticed her symptoms have progressively worsened.

On examination, Jane’s blood pressure was 154/64 mmHg with a heart rate of 124 bpm. Her skin was warm and moist. A fine hand tremor was noted and Jane’s reflexes were brisk. Neck examination revealed a small, non-tender goitre with no palpable nodules. Eye examination was normal with no lid retraction or lid lag present.

Hyperthyroidism

Jane’s clinical symptoms and signs suggest hyperthyroidism, of which there are multiple causes. The most common of these is Graves’ disease

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