A 53-year-old male presents to their GP complaining of ‘feeling unbearably hot’ for the last few weeks. On further questioning, the patient reveals this has been associated with his bowels being more ‘irregular and loose’ lately, with a ravenous appetite. There is no history of recent travel, night sweats or cough. There has been some recent weight gain of around 4kg. He currently lives with his wife and 2 children. He is currently taking Amlodipine for mild hypertension.
On examination, the patient is alert and orientated. His hands have a notable fine tremor and there is some detachment of the fingernails from the nail bed. There is also a swelling below the laryngeal prominence. Observations are normal apart from an irregularly irregular tachycardia at 112 bpm.
What is the most likely diagnosis given his current presentation?
- A. Pheochromocytoma
- B. Euthyroid hyperthyroxinaemia
- C. Hashimoto’s thyroiditis
- D. Grave’s disease
- E. Neuroleptic malignant syndrome
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