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A Case-Based Guide to Clinical EndocrinologyAutoimmune Hypothyroidism with Persistent Elevation of TSH

A Case-Based Guide to Clinical Endocrinology: Autoimmune Hypothyroidism with Persistent Elevation... Chapter 9 Autoimmune Hypothyroidism with Persistent Elevation of TSH Amit Allahabadia Objectives To understand the investigation and treatment of patients with autoimmune hypo- thyroidism, and to recognize causes of persistent thyroid-stimulating hormone (TSH) elevation despite adequate thyroxine treatment. Case Presentation A 39-year-old man presented to his primary care physician in January 2005 with a 4-month history of generalized aches and pains and tiredness. There also appeared to be increased stress in his work and personal life, and a trial of amitripty- line 25 mg/day was commenced. Although his symptoms improved, they did not resolve completely. Blood tests including thyroid function tests were performed and revealed marked hypothyroidism: TSH >150 mU/L, and free thyroxine (FT ) 3.0 pmol/L. He was referred to an endocrinologist and was seen in April 2005. A detailed history revealed a normally fit and active person who had been unable to perform his normal activities in the preceding few months. There was no history of neck swelling or pain. His skin had become very dry but with no pigmentation, he had become constipated, and he had dizziness on standing. There was no family history of thyroid disease but he had a sister and an aunt with http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologyAutoimmune Hypothyroidism with Persistent Elevation of TSH

Part of the Contemporary Endocrinology™ Book Series
Editors: Davies, Terry F.
Allahabadia, Amit
A Case-Based Guide to Clinical Endocrinology — Jan 1, 2008
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Publisher
Humana Press
Copyright
© Humana Press,Totowa, NJ 2008
ISBN
978-1-58829-815-7
Pages
85 –91
DOI
10.1007/978-1-60327-103-5_9
Publisher site
See Chapter on Publisher Site

Abstract

Chapter 9 Autoimmune Hypothyroidism with Persistent Elevation of TSH Amit Allahabadia Objectives To understand the investigation and treatment of patients with autoimmune hypo- thyroidism, and to recognize causes of persistent thyroid-stimulating hormone (TSH) elevation despite adequate thyroxine treatment. Case Presentation A 39-year-old man presented to his primary care physician in January 2005 with a 4-month history of generalized aches and pains and tiredness. There also appeared to be increased stress in his work and personal life, and a trial of amitripty- line 25 mg/day was commenced. Although his symptoms improved, they did not resolve completely. Blood tests including thyroid function tests were performed and revealed marked hypothyroidism: TSH >150 mU/L, and free thyroxine (FT ) 3.0 pmol/L. He was referred to an endocrinologist and was seen in April 2005. A detailed history revealed a normally fit and active person who had been unable to perform his normal activities in the preceding few months. There was no history of neck swelling or pain. His skin had become very dry but with no pigmentation, he had become constipated, and he had dizziness on standing. There was no family history of thyroid disease but he had a sister and an aunt with

Published: Jan 1, 2008

Keywords: Celiac Disease; Primary Hypothyroidism; Persistent Elevation; Tropical Sprue; Thyroid Failure

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