Endocrine Abstracts

A 29 year old lady with a background Hx of asthma came to the Ambulatory clinic with palpitations in the mid of Dec 2022. She was found to have an elevated heart rate of 120/min, regular and EKG showed Sinus Tachycardia. BP was Normal and weight was stable. She was also complaining of loose Bowls for the last few months. She denied any eye signs. She was a smoker and was not pregnant (She was not planning pregnancy in the near future). Her Bloods were Normal with stable U&E and CBC. However she had a fully suppressed TSH with TSH <0.01 and free T4 87 and T3 was raised at 35. Given these findings Endocrinology was called and we advised TRab levels which were raised at 19. O/E- She was not tremulous, vitals as mentioned above and smooth Goitre on palpation. She was started on Carbimazole and referred to Thyroid Clinic for a followup with repeat bloods in about 6-8 weeks. The Impression was GRAVE’S DISEASE. She also had a Halter which showed that she was sinus tact with nocturnal AV block (Mobitz type 2 ). This was discussed with Cardiology who advised no Rx, and as they regarded these findings as Normal for a young person.