T N. Lanham, Reading Hospital - Tower Health
A Sullivan, Reading Hospital - Tower Health
E Lanham, Jefferson
Anthony A. Donato, Reading Hospital - Tower Health


We present a case of thyrotoxicosis provoked by mechanical trauma to the neck in the setting of previously undiagnosed subclinical Graves' disease.33‐year‐old female smoker with history of postpartum weight loss, tremors, and goiter one year prior presented with dyspnea, progressive neck pain and swelling 2 days after being strangled by her boyfriend. She endorsed palpitations, chest tightness, tremors, and anxiety and nightmares. She denied diarrhea, radiation exposure, and thyroid cancer. On exam, patient was afebrile, normotensive (129/87 mmHg), but tachycardic (130s bpm). Patient had no altered mentation, but anxiety and a fine intention tremor was noted with diffuse thyromegaly (2.5 times normal) which was tender to palpation, and abrasion marks and bruises on her neck. No pretibial or ophthalmic changes were seeen. Labs were remarkable for thyroid stimulating hormone (TSH)