Not a Grave Finding: Thymic Hyperplasia in the Setting of Graves’ Disease

Abstract

A 30-year-old Caucasian male with no previous medical history presented to the emergency department with sudden onset chest pain brought on by exertion at work. He had never experienced similar episodes before, and chest pain was described as severe, mid-sternal, non-radiating, and was associated with palpitations, dyspnea, and near-syncope. Patient also reported unintentional weight loss of 40 pounds over the 3 months leading up to presentation. Review of systems was positive for diaphoresis, increased anxiety, heat intolerance, and a mild hand tremor for several weeks. He denied cough, changes in vision or voice, nausea, vomiting, diarrhea, constipation, or abdominal pain. He reported no history of tobacco or illicit drug use and no family history of thyroid disease or autoimmune conditions.