A 72-year-old man presented to the emergency department with progressive fatigue and intolerance to cold. He had a history of hypothyroidism and had chosen to discontinue his levothyroxine supplementation 6 months earlier. On examination, the patient was alert, with a temperature of 36[degrees]C, blood pressure of 147/70 mm Hg, heart rate of 98 beats/minute and respiratory rate of 16 breaths/minute. We observed loss of the outer third of the eyebrows (i.e., the Queen Anne sign, Figure 1), periorbital edema, xerosis and thin hair. His mental status examination raised concern for the presence of delusions related to his medical care. The patient's thyrotropin level was 204 (normal 0.35-4.94) mIU/L, his free thyroxine and triiodothyronine levels were undetectable, and his creatine kinase (874 IU/L, normal [less than or equal to] 240) and serum creatinine (166 [micro]mol/L, normal 64-110) levels were...
Queen Anne sign.
From: CMAJ: Canadian Medical Association Journal(Vol. 194, Issue 6)
Publisher: CMA Impact Inc.
Document Type: Clinical report
Length: 553 words
Lexile Measure: 1630L
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