A 30-year-old woman comes to the office due to a 4 days history of anterior neck pain. The patient had an upper respiratory infection a month ago, during which she experienced nasal congestion, rhinorrhea, and a cough productive of clear sputum; her respiratory symptoms lasted for 5 days and resolved spontaneously. She has no history of serious illness On examination, mild fever, palpitations, and excessive sweating. Pulse is 110/min. The thyroid gland is tender to palpation and diffusely enlarged. Laboratory studies show suppressed TSH and elevated free thyroxine levels. Erythrocyte sedimentation rate is 70 mm/hr.
Which of the following additional findings is most likely to be present in this patient at this time?

Question

Quizplus · Accepted Answer

Eductional Objective: Subacute (granulomatous, de Quervain) thyroiditis presents with fever; a painful, tender goiter; and an elevated erythrocyte sedimentation rate.  Patients initially develop hyperthyroidism due to the destruction of thyroid follicles and release of preformed thyroid hormone.  TSH is suppressed due to feedback inhibition on the pituitary; as a result, thyroid metabolic activity and organification of iodine are decreased, and radioactive iodine uptake is low.

A 30-Year-Old Woman Comes to the Office Due to a 4