Abstract

A 54-year-old woman presented to the emergency room with dyspnea, hoarseness, dysphagia, and anterior neck swelling of 2 weeks. Her past medical history was significant for a thyroid nodule status post fine needle aspiration showing lymphocytic thyroiditis and Hashimoto hypothyroidism, which was treated with 125 μg of levothyroxine daily. Family history was noncontributory. Physical examination showed that she was in acute distress, with dyspnea and biphasic stridor, a heart rate of 88 bpm, blood pressure of 130/80 mm Hg, oxygen saturation of 92% in room air, and temperature of 98.5°F.

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