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Palpation of the neck revealed the presence of goiter. Results of blood tests indicated elevated concentrations of thyroid hormones (thyroxin and triiodothyronine), hypercalcemia, and decreased circulating concentrations of lipids.
Based on the physical characteristics and the results of the blood tests, Michael's physician suspected that Michael was suffering from some form of hyperthyroidismand sent him to an endocrinologist to confirm the initial diagnosis.Following the initial consultation and examination, the endocrinologist ordered tests to determine whether Michael was indeed hyperthyroid. The test results indicated an elevation in the concentration of thyroid hormones in the blood and the presence of thyroid-stimulating antibodies. These antibodies specifically stimulate the thyroid gland by binding with the thyroid stimulating hormone receptor located on the plasma membrane of the follicular cells of the thyroid gland. Based on these results, the endocrinologist concluded that Michael had Grave's disease, a form of hyperthyroidism believed to be autoimmune in nature. Michael was presented with a number of possible treatment options. These included treatment with chemicals (propylthiouracil and methimazole) that decrease the production of thyroid hormones by the