A 34-year old man had a two-month history of weight loss, palpitations, night sweating, low-grade fever, and neck pain. His past history was unremarkable, he took no medications including over-the-counter medications before the illness, had no known allergies, and did not drink alcohol or use illicit drugs. Physical examination revealed a tender goiter. Laboratory findings showed neutrophil leukocytes 12,161/mm3, C-reactive protein 36.8mg/L (normal<10), FT3 8.30pg/mL (normal 2.3–4.2), FT4 4.37ng/mL (normal 0.8–1.60), thyroglobulin 87.2ng/mL (normal 1.3–31.8), and TSH<0.008 uIU/mL (normal 0.30–4.50).
