A 60-year-old woman presents with facial puffiness, voice hoarseness, and generalized swelling. She also reports fatigue and unexplained weight gain. What could be the potential causes, and what are the next steps?
The symptoms of facial puffiness, hoarseness, generalized swelling, fatigue, and weight gain are suggestive of hypothyroidism. Other potential causes could include renal disease, heart failure, or a systemic autoimmune condition. The next step would be to order thyroid function tests, including serum TSH and free T4 levels.