IPLab:Lab 6:Hashimoto's Thyroiditis: Difference between revisions - Pathology Education Instructional Resource

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== Clinical Summary ==

This was a 49-year-old woman who complained ~~during her yearly physical examination~~ of tiredness and difficulty concentrating~~. She attributed these symptoms to stress at work~~. She had gained weight over the last year and despite warm weather, she felt chilled without a sweater. Family history was significant for hypothyroidism in her mother and older sister. On physical examination she had ~~a pulse of 58 bpm and a blood pressure of 138/88 mm Hg. Examination of her neck disclosed a small~~ thyroid gland with ~~a palpable pyramidal lobe and~~ a firm, bosselated texture. Serum ~~taken at this time demonstrated a total T4 of 7.0 mcg/dL and a~~ TSH ~~of 22.0 mcIU/ml. In addition, antithyroglobulin antibodies were positive at 1 to 640~~ and ~~antimicrosomal~~ antibodies were positive ~~at 1 to 5120~~. These results supported the clinical impression of hypothyroidism; also, the texture of her thyroid gland and a positive family history suggested an autoimmune etiological factor. She was referred to an endocrinologist ~~for further evaluation~~; however, before beginning treatment she died suddenly from a ruptured berry aneurysm ~~of the middle cerebral artery~~.

This was a 49-year-old woman who complained of tiredness and difficulty concentrating. She had gained weight over the last year and despite warm weather, she felt chilled without a sweater. Family history was significant for hypothyroidism in her mother and older sister.

On physical examination she had an enlarged thyroid gland with a firm, bosselated texture. Serum TSH was markedly elevated and antithyroid peroxidase antibodies were positive. These results supported the clinical impression of hypothyroidism; also, the texture of her thyroid gland and a positive family history suggested an autoimmune etiological factor. She was referred to an endocrinologist; however, before beginning treatment she died suddenly from a ruptured berry aneurysm.

== Autopsy Findings ==

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 == Clinical Summary ==
-This was a 49-year-old woman who complained during her yearly physical examination of tiredness and difficulty concentrating. She attributed these symptoms to stress at work. She had gained weight over the last year and despite warm weather, she felt chilled without a sweater. Family history was significant for hypothyroidism in her mother and older sister. On physical examination she had a pulse of 58 bpm and a blood pressure of 138/88 mm Hg. Examination of her neck disclosed a small thyroid gland with a palpable pyramidal lobe and a firm, bosselated texture. Serum taken at this time demonstrated a total T4 of 7.0 mcg/dL and a TSH of 22.0 mcIU/ml. In addition, antithyroglobulin antibodies were positive at 1 to 640 and antimicrosomal antibodies were positive at 1 to 5120. These results supported the clinical impression of hypothyroidism; also, the texture of her thyroid gland and a positive family history suggested an autoimmune etiological factor. She was referred to an endocrinologist for further evaluation; however, before beginning treatment she died suddenly from a ruptured berry aneurysm of the middle cerebral artery.
+This was a 49-year-old woman who complained of tiredness and difficulty concentrating. She had gained weight over the last year and despite warm weather, she felt chilled without a sweater. Family history was significant for hypothyroidism in her mother and older sister.
+On physical examination she had an enlarged thyroid gland with a firm, bosselated texture. Serum TSH was markedly elevated and antithyroid peroxidase antibodies were positive. These results supported the clinical impression of hypothyroidism; also, the texture of her thyroid gland and a positive family history suggested an autoimmune etiological factor. She was referred to an endocrinologist; however, before beginning treatment she died suddenly from a ruptured berry aneurysm.
 == Autopsy Findings ==