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April 12, 2024

A 40-year-old female presents with a 3-week history of a persistent sore throat despite supportive treatment

A 40-year-old female presents with a 3-week history of a persistent sore throat despite supportive treatment for a viral upper respiratory infection provided by an urgent care facility. Two COVID-19 polymerase chain reaction tests separated by 5 days were negative during this time. She reports palpitations, weight loss, frequent bowel movements, and anxiety with insomnia for the past month. With further evaluation, you determine that the throat pain she describes is actually localized to the anterior neck when you palpate that area. On examination she has a mildly enlarged thyroid gland. A laboratory evaluation is notable for a suppressed TSH level along with elevated free T4 and total T3 levels. A radioactive iodine uptake scan shows low uptake. What is the most likely diagnosis?

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