Clinical Case 3.2

A 35-year-old woman came to the outpatient clinic with her 5-month-old child. She had noted increasing tenseness and irritability with her baby, poor sleep, weight loss and palpitations. Her husband was concerned that she had post-natal depression and had taken time off work to look after the family. She had an unremarkable past medical history and had sailed through pregnancy without any problems; she denied depression but felt exhausted all the time. She recalled that her late mother had an operation on her neck in her twenties and that her younger sister had regular vitamin injections for anemia. She ruefully admitted that the recent strain had led her to restart smoking ten cigarettes daily. On examination, she had a moderate diffuse goiter with an audible bruit, a tremor and a resting tachycardia of 100/min. Her eyes were prominent and puffy (see Box 3.16).

Box Icon

Box 3.16

Associated features of Graves' disease — the eye. Periorbital edema — swelling around the eye, the result of accumulation of mucopolysaccharides and associated water. Chemosis — swelling and redness of the conjunctivae Image dclcc1.jpg Lachrymal (more...)

From: Chapter 3, The thyroid gland

Cover of Endocrinology
Endocrinology: An Integrated Approach.
Nussey S, Whitehead S.
Copyright © 2001, BIOS Scientific Publishers Limited.

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