A 42-year-old woman presents with progressive fatigue, weight gain, cold intolerance, and constipation over three months. Vital signs show HR 52 bpm, BP 138/88 mmHg, temperature 36.2°C. Laboratory studies reveal TSH 8.5 mIU/L and free T4 0.7 ng/dL. Thyroid peroxidase antibodies are elevated at 245 IU/mL. She denies current medications including lithium or amiodarone. Physical examination reveals a firm, nontender, diffusely enlarged thyroid gland without discrete nodules. Which diagnosis best explains these findings?
- A)Thyroid lymphoma
- B)Graves' disease
- C)Secondary hypothyroidism from pituitary adenoma
- D)Central hypothyroidism
- E)Hashimoto's thyroiditisGABARITO
Explicação
The clinical presentation of hypothyroidism (fatigue, weight gain, cold intolerance, constipation) with elevated TSH and low free T4 indicates primary hypothyroidism. Hashimoto's thyroiditis is the most common cause of hypothyroidism in iodine-sufficient regio... Ver explicação completa e trilha adaptativa →