Carl Deetz

At a Glance Subacute thyroiditis is a biphasic entity that can present as diffuse thyroid inflammation, swelling, and hyperthyroidism in the early phase of the disease. The presenting symptoms of hyperthyroidism include heat intolerance, weight loss, diarrhea, increased appetite, tremor, and irritability. This hyperthyroid period is followed by a late phase of hypothyroidism with opposing…

At a Glance Toxic adenoma along with toxic multinodular goiter may be the leading cause of hyperthyroidism in countries in which iodine deficiency is common. Toxic adenomas produce elevated amounts of free thyroxine (fT4). The presenting symptoms of a toxic adenoma may be the same as the presenting symptoms for hyperthyroidism: heat intolerance, weight loss,…

At a Glance Toxic multinodular goiter (TMG) is the second leading cause of hyperthyroidism after Grave’s disease in developed countries but may be the leading cause of hyperthyroidism in countries in which iodine deficiency is common. Iodine deficiency can lead to a goiter formation with repeated cycles of involution and hyperplasia, subsequently resulting in nodule…

At a Glance Euthyroid sick syndrome is diagnosed in patients with low thyroid hormone levels suffering from some nonthyroidal systemic illness that may include nutritional deficits, kidney disease, liver disease, malignancy, trauma, or infection. This is commonly seen in the hospital setting and intensive care units, in particular. These patients are usually clinically euthyroid. What…

At a Glance Thyroid storm is an acute and severe hypermetabolic episode that can include fever, tachycardia, hypertension, diarrhea, neurologic abnormalities, and death. Profound and rapid thyroid hormone release leads to severe hypermetabolism with these clinical manifestations. What Tests Should I Request to Confirm My Clinical Dx? In addition, what follow-up tests might be useful?…