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A Case-Based Guide to Clinical EndocrinologySubclinical Hyperthyroidism Due to a Multinodular Thyroid

A Case-Based Guide to Clinical Endocrinology: Subclinical Hyperthyroidism Due to a Multinodular... Chapter 6 Subclinical Hyperthyroidism Due to a Multinodular Thyroid Paul Aoun and David S. Cooper Objectives Subclinical hyperthyroidism is defined as a state of mild thyroid overactivity, in which serum free thyroxine (T ) and free triiodothyronine (T ) levels are within the 4 3 normal range but serum thyroid-stimulating hormone (TSH) levels are subnormal. Whether the serum TSH level needs to be extremely low (e.g., undetectable), very low (e.g., <0.1mU/L), or simply just below the lower limit of normal of the typical TSH assay (e.g., <0.4mU/L) remains somewhat controversial. We report the case of a 50-year-old woman with mild hyperthyroidism due to a multinodular thyroid. We review the issues surrounding establishing the diagnosis, and discuss risks and benefits of treatment in this individual. Case Presentation Ms. D.W. is a 48-year-old premenopausal woman who was found by her primary care physician to have abnormal thyroid function tests during routine screening as part of her annual physical examination. At that time, she was noted to have a serum TSH of 0.17 mU/L. She was referred to the endocrine clinic for further evaluation. She had no prior history of thyroid disease and no family history of thyroid disease. She had no http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png

A Case-Based Guide to Clinical EndocrinologySubclinical Hyperthyroidism Due to a Multinodular Thyroid

Part of the Contemporary Endocrinology™ Book Series
Editors: Davies, Terry F.
Aoun, Paul; Cooper, David S.
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
61 –66
DOI
10.1007/978-1-60327-103-5_6
Publisher site
See Chapter on Publisher Site

Abstract

Chapter 6 Subclinical Hyperthyroidism Due to a Multinodular Thyroid Paul Aoun and David S. Cooper Objectives Subclinical hyperthyroidism is defined as a state of mild thyroid overactivity, in which serum free thyroxine (T ) and free triiodothyronine (T ) levels are within the 4 3 normal range but serum thyroid-stimulating hormone (TSH) levels are subnormal. Whether the serum TSH level needs to be extremely low (e.g., undetectable), very low (e.g., <0.1mU/L), or simply just below the lower limit of normal of the typical TSH assay (e.g., <0.4mU/L) remains somewhat controversial. We report the case of a 50-year-old woman with mild hyperthyroidism due to a multinodular thyroid. We review the issues surrounding establishing the diagnosis, and discuss risks and benefits of treatment in this individual. Case Presentation Ms. D.W. is a 48-year-old premenopausal woman who was found by her primary care physician to have abnormal thyroid function tests during routine screening as part of her annual physical examination. At that time, she was noted to have a serum TSH of 0.17 mU/L. She was referred to the endocrine clinic for further evaluation. She had no prior history of thyroid disease and no family history of thyroid disease. She had no

Published: Jan 1, 2008

Keywords: Multinodular Goiter; Antithyroid Drug; Subclinical Hyperthyroidism; Radioactive Iodine Therapy; Overt Hyperthyroidism

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