An 11-year-old female with no significant past medical history presented with symptoms suggestive of hyperthyroidism (weight loss, heat intolerance). She has also experienced a decline in grades at school. Family history is significant for thyroid disease in both grandmothers (both on thyroid replacement therapies).
The results of the lab tests are as follows: Free thyroxine (FT4) 2.87 ng/dL (Prepubertal 0.73-1.77 Pubertal/Adult 0.73-1.84) Total triiodothyronine pediatric (T3) 374.00 ng/dL (123-211) Thyroid-stimulating hormone (TSH) <0.018 uU/ml - Thyroxine (T4) 18.2 ug/dL (5.0-12.0) Antithyroglobulin antibodies >3000 IU/ml (Negative <60 IU/mL Equivocal 60-100IU/mL Positive >100 IU/mL) Antithyroid peroxidase antibodies 2667 IU/mL (<60) Anti-TSH receptor antibodies 69.6 % Inhibit. (<=16.0 Unit: %) What is the diagnosis and which treatment plan would you suggest? *This case is by…
