Patient: During the week of January 6-13, 2012, the symptoms of rapid heartbeat and panic attack continued to occur in the evening, and then went to the hospital for examination, and the doctor suggested checking the nail function, and the results came out on January 16: TT3 2.89 (normal 0.6-1.8); TT4 13.77 (normal 4.5-10.9); FT3 8.66 (normal: 2.3-4.2); FT4 2.81 ( Normal 0.89-1.76); TSH 0.017 (Normal 0.35-5.5); TGAB >500.0 (Normal 0-70); TPOAB >1300.0 (Normal 0-70), the doctor recommended iodine absorption rate test Note: test of liver function, propylglutamic aminotransferase was high, 70, Normal: 5-40, Glutamic oxal aminotransferase vote high 46, Normal: 10-28; this During the period of appetite, weight gain, excessive sweating February 8, 2012 iodine absorption rate test results: 2-hour iodine absorption rate 29.57%, and 24-hour iodine absorption rate ratio 52.59%; 4-hour iodine absorption rate 37.44, and 24-hour iodine absorption rate ratio 66.58%; 24-hour iodine absorption rate 56.24, and 24-hour iodine absorption rate ratio of,100.; diagnosis: thyroid 2-hour Slightly increased iodine absorption rate February 9, 2012 Symptoms: excessive sweating, decreased heartburn, easily tired, weight gain. Thyroid ultrasound results: diffuse symmetric enlargement of both lobes of the thyroid gland, right lobe thickness 1.8CM, left lobe thickness 1.4CM, isthmus thickness 0.4CM, smooth surface of the gland, internal echogenicity is not uniform, visible multiple flaky hypoechoic, no obvious nodules. cdfi: gland blood flow signal is rich, ultrasound suggests: diffuse thyroid lesions, doctor suggested to do a second thyroid function test February 2012 10th thyroid function test result FT3 7.71 (normal 2.3-4.2); FT4 2.37 (normal 0.89-1.76); TSH-3 0.01 (normal 0.35-5.5); TRAB 19.2 (normal <30). In the blood routine: white blood cells 8.05 (normal 4-10), normal; the doctor confirmed the diagnosis of hyperthyroidism, but continued weight gain, average appetite, constipation. Doctor prescribed medication: propylthiouracil tablets. Fear of weight gain, did not take March 9, 2012 Nail function test results FT3 5.64 (normal 2.3-4.2); FT4 1.74 (normal 0.89-1.76); TSH-3 0.02 (normal 0.35-5.5); blood routine: white blood cells than the previous month has decreased, 6.83 (normal 4-10) April 6, I just took a new one today Labs, results are as follows: 1. TRAB 3.96 (reference range <2.5) 2. A-TPO 239.40 (reference range <34) 3. A-Tg 285.00 (reference range <115) 4. FT3 3.99 (reference range 1.80-4.10) 5. FT4 1.420 (reference range 0.81-1.89) 6. 1.900 (Ref. range 0.66-1.92) 7.T4 11.3 (Ref. range 4.30-12.50) 8.TSH3 0.006 (Ref. range 0.38-4.34) No treatment has been given, avoid iodine-containing foods and seafood What is the diagnosis? Jia Hongli: Your case should be the combination of bridge nail infection and subluxation, subluxation is a self-healing disease, no medication, if the sore throat short-term use of prednisone, panic with cardiac glycosides to control the symptoms. Antithyroid drugs are prohibited. Later, you should pay attention to the occurrence of hypothyroidism. You are more likely to have hypothyroidism if you have combined with Hashi's thyroiditis, if hypothyroidism occurs, timely supplementation of eugenol. Recently, monthly thyroid tests should be performed to monitor the occurrence of hypothyroidism. The analysis of the disease is as follows: 1. Is there a history of colds before January? If so, this adds one more piece of evidence for the diagnosis of hypothyroidism.2. If iodine absorption was done in January, the rate should be low and the sedimentation rate should be fast. The thyroid should have been superficially visualized or even not visualized.3. A mild increase in iodine absorption in February proved that the thyroid function was in the recovery stage. This should have been double confirmed by another thyroid imaging at that time. Persistent weight gain, average appetite, and constipation are all symptoms of hypothyroidism. Be alert for hypothyroidism. 4. In March, the thyroid function decreased, TRab (-). This again confirms that the patient is not hyperthyroid; if he were hyperthyroid, the TRab would be (+). 5. In April, the AF is normalized, but the TRab is (+). This is a sign of conversion to hypothyroidism. Both true hyperthyroidism and hypothyroidism will have TRab (+). And metritis TRab (-).