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Durga Nair ,29yrs/F 11/11/11

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Provisional Diagnosis-Hypothyroidism/Thyroiditis ?Myasthenia Gravis
Final Diagnosis-Neuromyasthenia Thyroiditis Vit D def state
History and Findings-A k/c/o Hypothyroidism since 2008 Comprehensive check up AIMS 2/02/09-TMT Neg,DLP-On Rx Wt loss/Tiredness/Lethargy/Muscle weakness/Cold intolerance/hair fall since Jan 2011. Pain both shoulders/Hips since 2009
Investigation-Hb-12.5,ESR-14,CRP-0.24,HBA1c-5.1%,Creatinine-0.7,Uric-4.1,ca-9.4,A/g-4.78/3.5,LFT-Normal,Cortisol-7.4,TSH-3.86,ATg-71.15,TPO-973.56,FT3-2.24,Na-139.2,K-3.8,Stool fat +ve,OB-Neg,25(OH)vit D-13.93,Urine-N,ECG-Wnl,RAF-Neg,ASO-Neg,Cxr-N,no e/o thymonma,NCV & RNS studies normal,anti acetylcholine receptor antibody (Ach R ab)<0.15(NR-0.25-0.40)
Treatment-Continue LT4 as before Calcirol Milical Daxid(Sertaline)
Follow Up-Since pt is in US adv to contact by phone regarding dose adjustment
doctor bhaskaaran

doctor bhaskaaran

wkfvcepdupscibtlbsbo, http://www.lmyhjkaety.com iaroburchp

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