女性,72岁,因乏力、低热伴双手震颤半年于1999年5月13日来我院就诊,患者呼吸时感气短以及吞咽困难,体重在1个月内减轻约2.5kg,既往体健。体格检查:体温37.5℃,无突眼;甲状腺中度肿大,双侧对称,无肿块、压痛,无杂音:心肺正常;腹软,肝脾肋下未扪及肿大,双下肢胫前无水肿,四肢肌力正常,双手震颤(+)。实验室检查:血、尿、 Female, 72 years old, came to our hospital on May 13, 1999 because of weakness and fever accompanied by tremor of hands. The patient experienced shortness of breath and difficulty swallowing when breathing. The weight of body weight was reduced by 2.5kg within one month and was previously healthy. Physical examination: body temperature 37.5 ℃, no exophthalmos; moderate enlargement of the thyroid gland, bilateral symmetry, no lumps, tenderness, no noise: normal heart and lung; abdominal soft, liver and spleen ribs palpable enlargement, both lower extremities anterior tibial Edema, normal limbs, tremor in both hands (+). Laboratory tests: blood, urine,