case history

I saw a patient today who is nearly touching her eighties. She was diagnosed to have thyrotoxicosis 14 years ago and had been on anti thyroid drugs for nearly 13 years before she decided to stop it 6 months ago. She went to a gastroenterologist 2 weeks back with increased stool frequency. She was referred to me by the GE after a complete GI evaluation. Examination was unremarkable except for an enlarged left lobe of the thyroid. Thyroid function test ws suggestive of a thyrotoxic state. I made a diagnosis of apathetic toxicosis and started her on antithyroid drugs again. I also advised her to bring her old records.