Abstract
Subclinical hyperthyroidism appears to be a common disorder. It may be caused by exogenous or endogenous factors: excessive TSH suppressive therapy with L-thyroxine (L-T4) for benign thyroidnodular disease, differentiated thyroid cancer, or hormone over-replacement in patients withhypothyroidism are the most frequent causes. Consistent evidence indicates that subclinicalhyperthyroidism reduces the quality of life, affecting both the psycho and somatic components ofwell-being, and produces relevant signs and symptoms of excessive thyroid hormone action, oftenmimicking adrenergic overactivityJ MEDICINE January 2016; 17 (1) : 39-40
Highlights
Subclinical hyperthyroidism a common clinical entity is caused by exogenous or endogenous factors
Subclinical hypothyroidism is defined as a serum thyroid stimulating hormone (TSH) above the defined upper limit of the reference range, with a serum free thyroxine (T4) within the reference range
If low serum TSH is found in the absence of thyroid hormone use, it is labeled ‘endogenous’
Summary
Subclinical hyperthyroidism a common clinical entity is caused by exogenous or endogenous factors. The commonest causes include excessive TSH suppressive therapy with Lthyroxine(L-T4) for benign thyroid nodular disease, differentiated thyroid cancer or hormone overreplacement of hypothyroidism. On examination patient was conscious and oriented. His BP was 150/90 mmHg and pulse rate of 60/ min regular. The examination of abdominal, respiratory and central nervous system were normal. His routine laboratory investigations including Hb, TLC, DLC, Na+, K+ ,Blood sugar, HbA1C were within normal limits. Echocardiography showed normal ejection fraction with mild tricuspid regurgitation, pulmonary hypertension and left ventricular hypertrophy. Thyroid profile revealed TSH 0.002mU/l, tri-iodothyronine (T3) 150 ng/dl and free thyroxine (T4) 1.5 ng/dl. After undergoing thyroid ablation therapy his TSH was normalized and his ECG showed first degree heart block
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