Case Presentation A 40-year-old man presented to the emergency department with a subacute onset of postural instability, diplopia, generalized fatigue, and diffuse myalgia. He appeared weak and slow in both movement and speech.
Physical Examination General: Periocular edema present, slow speech, no hepatosplenomegaly Vital signs: Heart rate 60 bpm, blood pressure 110/70 mmHg Neurological exam: Unremarkable Laboratory Findings TSH: 172 μU/mL Free T4: 0.04 ng/dL Creatine kinase (CK): 4588 U/L Creatinine: 1.48 mg/dL eGFR: 59.2 mL/min/1.73m² Anti-thyroid peroxidase antibodies: Elevated Immunology and Imaging Anti-thyroid peroxidase antibodies: Elevated (supports autoimmune thyroiditis) Thyroid ultrasound: Small, hypotrophic, slightly hyperechoic gland with heterogeneous echotexture (Cover Image) Reference : Cureus ##Disclaimer## The content provided on Docplexus is intended for educational…
