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Pathology
A 20-year-old woman and her twin sister both experience increasing diplopia. Their conditions develop within 3 years of each other. On physical examination, they have exophthalmos and weak extraocular muscle movement. The thyroid gland is diffusely enlarged but painless in each sister, and there is no lymphadenopathy in either woman. Which of the following serum laboratory findings is most likely to be reported in these sisters?
Decreased free thyroxine level
Decreased thyroid-stimulating hormone level
High titer thyroid peroxidase autoantibodies
Increased thyrotropin-releasing hormone level
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