Thank you for seeing Ms Duval, a 30-year-old university student, who requires an early assessment of her progressive weight loss of ten kilograms over the last two months: possible Grave DiseaseGraves' disease.

Ms Duval presented to me on 31.05.2014, seemed perturbed with significant weight droploss, despite having regular eating habits. It was associated with tremors, episodic palpitations, sweating, and heat intolerance forover the last two months;, with an associated history of fatigue since the previous month.


On clinical examination, I identified the overt signs of hyperthyroidism: tender and slightly enlarged thyroid gland;, exophthalmos accompanied with lid leg;, and hand tremors. Ms Duval was afebrile, and her vital signs were unremarkable.

Therefore, I organised a work-up for the thyroid gland. An ECG was done which did not delineate any cardiac abnormality;, routine blood tests showed no aberrant results, and thyroid function tests identified raised Thyroxinethyroxine levels with decreased levels of TSH. ThyroidA thyroid antibody test and a thyroid scan have been requested, awaiting reports.

Given the context above, I would be grateful if you could attendtend to Ms Duvan at your earliest convenience, as she is concerned about her possible diagnosis mentioned earlier. I have conferred with her about GraveGraves' disease.

I would be pleased to answer should you have any queries; please do not hesitate to contact me.

Yours sincerely,