MRCEM Notes

Thyrotoxicosis

Graves' disease accounts for around 70% of cases of thyrotoxicosis.

Causes
  • Graves' disease
  • toxic nodular goitre
  • acute phase of subacute (de Quervain's) thyroiditis
  • acute phase of post-partum thyroiditis
  • acute phase of Hashimoto's thyroiditis (later results in hypothyroidism)
  • amiodarone therapy

Investigation
  • TSH down, T4 and T3 up
  • thyroid autoantibodies
  • other investigations are not routinely done but includes isotope scanning

Venn diagram showing how different causes of thyroid dysfunction may manifest. Note how many causes of hypothyroidism may have an initial thyrotoxic phase.
Full-size image