Graves’ Disease

This post is an answer to the Case – Patient with Fatigue, Diaphoresis, Cachexia

Thyrotropin levels were suppressed, at 0.01 mIU per liter (reference range, 0.49 to 4.67). Total levels of triiodothyronine and thyroxine were elevated, at 791 ng per deciliter (reference range, 79 to 149) and more than 24 μg per deciliter (reference range, 4.5 to 12), respectively.

The results of an immunoassay for levels of unbound triiodothyronine and thyroxine were not available. The patient received a diagnosis of Graves’ disease.

Treatment with propranolol and methimazole resulted in a substantial improvement in fatigue, tremulousness, and tachycardia within 1 week. She was thereafter lost to follow-up.