Chapter 16, Problem 16Q

Summary Introduction

Case summary:

A patient, age 19 years reported with increased sweating, insomnia, palpitations and enlarged thyroid gland which upon investigation revealed an autoimmune disorder called Grave's disease.

Characters in the case:

Courtney Povlosky, the patient under evaluation.

Adequate information:

The patient's blood investigations show elevated T3 and T4 levels but lower than normal TSH levels compared to reference ranges. Further antibody tests confirmed the presence of anti-TSH receptor antibodies in her serum. She was treated with an antithyroid drug to which she responded well.

To Determine:

The reason why patients with Grave's disease have low TSH levels though their symptoms are that of hyperthyroidism.