Case 3. Hashimoto’s thyroiditis :
Type IV Autoimmune disease
Complete blood count was notable anemia (hemoglobin 11,3 g/dl). Her T4 level was low (1,9 μg/dl), TSH level was elevated at 25 mIU/L, and serum antithyroid peroxidase and antithyroglobulin autoantibodies were detected. Antithyroid-stimulating hormone receptor antibody was negative. She was given a diagnosis of autoimmune (Hashimoto’s) thyroiditis on the basis of the low T4 level, elevated TSH, and the autoantibody profile and was treated with thyroid replacement. Her TSH levels normalized and the anemia resolved and she noted a gradual decrease in her fatigue. Her skin and hair dryness improved.