Images in endocrine pathology: Thyrotoxicosis associated with destructive thyroiditis

摘要

A 49-year-old male had been diagnosed at birth with tricuspid atresia with ventricular and septal defects. He underwent multiple cardiac surgeries including a Glenn anastomosis and a modified Fontan procedure with a right atrium to right ventricle Carpentier-Edwards valve bioprosthesis. In a visit to the adult congenital cardiac clinic, he reported a 6-8-week history of increasing dyspnea on exertion, fatigue, swelling of the right leg, and intermittent tremor. The thyroid gland was of normal size. Laboratory investigation revealed thyrotro-pin less than 0.05 mIU/L (normal, 0.35-4.94 mIU/L), free T3 11.9 pmol/L (normal, 2.6-5.7 pmol/L), and free T4 77 pmol/L (normal, 9-19 pmol/L) consistent with thyrotoxicosis. No evidence of ophthalmopathy was noted. He was admitted for a therapeutic thyroidectomy.