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This Journal feature begins with a case vignette highlighting a common clinical problem. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. The article ends with the author's clinical recommendations.
A 23-year-old woman presents with palpitations. Over the past 6 months, she has reported loose stools, a 10-lb (4.5-kg) weight loss despite a good appetite and food intake, and increased irritability. She appears to be anxious and has a pulse of 119 beats per minute and a blood pressure of 137/80 mm Hg. Her thyroid gland is diffusely and symmetrically enlarged to
The Clinical Problem
Strategies and Evidence
Evaluation
Clinical Manifestations
Laboratory Studies
Imaging Studies
Tests for Ophthalmopathy
Other Diagnostic Studies
Therapy
Pharmacologic Therapy
Radioiodine Therapy
Surgery
Treatment for Ophthalmopathy
Graves' Disease and Pregnancy
Areas of Uncertainty
Guidelines from Professional Societies
Conclusions and Recommendations
Source Information
From the Veterans Affairs Greater Los Angeles Healthcare System, and the Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA — both in Los Angeles.
An audio version of this article is available at www.nejm.org.
Address reprint requests to Dr. Brent at the Endocrinology and Diabetes Division, 111D, Veterans Affairs Greater Los Angeles Healthcare System, 11301 Wilshire Blvd., Los Angeles, CA 90073, or at gbrent@ucla.edu.
This article has been cited by other articles:
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