A 68-year-old man with chronic atrial fibrillation on warfarin presents with fatigue, weight loss, and heat intolerance. TSH is suppressed at 0.08 mIU/L and free T4 is elevated at 22 pg/dL. Thyroid ultrasound shows multiple nodules without suspicious features. TSH receptor antibodies (TRAb) are negative. Which of the following is the most likely diagnosis?
- A)Subacute thyroiditis
- B)Toxic multinodular goiterGABARITO
- C)Graves disease
- D)Thyroid hormone contamination from warfarin interaction
- E)Secondary hyperthyroidism from pituitary adenoma
Explicação
Toxic multinodular goiter presents with suppressed TSH, elevated free T4, multiple thyroid nodules on imaging, and negative TSH receptor antibodies. It typically affects older patients and develops gradually from long-standing nodular goiter as nodules gain au... Ver explicação completa e trilha adaptativa →