A 52-year-old female presents with tiredness.
There are no specific abnormalities noted on examination, but investigations reveal:
T4 21.1 pmol/L (10-22)
T3 5.2 pmol/L (5-10)
TSH 0.05 mU/L (0.4-5)
Thyroid autoantibody titres are all undetectable.
Which diagnosis do these results suggest?
De Quervain’s thyroidits
Graves’ disease
Hashimoto’s thyroiditis
Sick euthyroid syndrome
Solitary toxic nodule This is the correct answer
This patient has subclinical hyperthyroidism and, in the absence of thyroid auto-antibodies, the most
probable explanation of these thyroid function abnormalities is a solitary toxic nodule.