Probable Hyperthyroidism
The history of increased appetite (without weight gain) and increased bowel motility is classic
for hyperthyroidism. The resting heart rate is mildly elevated, which is consistent but is a common
finding in physician's offices. The findings of an ocular stare, lid lag, and an enlarged thryoid
are also consistent with hyperthyroidism.
The orbital symptoms noted here are most typically associated with Grave's disease and result from
inflammation and swelling of retro-orbital tissues (this effect is separate from the elevation in
thryoid hormone). However, in this case the thyroid is asymmetrical and contains a nodule, whereas
the thyroid gland in Grave's disease is symmetrically enlarged and homogeneous.
Return to case 1