Riedel thyroiditis Quiz: Ace Your Exams

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A 34-year-old woman comes to the physician due to irregular menses for the past 3 months. She states that previously her menses occurred every 28-30 days and lasted 4-5 days. She also notes excessive fatigue and recent weight gain of 9-lb in 2 months. She uses topical betamethasone for treatment of vitiligo, and she recently started taking laxatives several times a week to help with bowel movements. Temperature is 36.5°C (97.7°F), pulse is 52/min, blood pressure is 122/82 mm Hg, and BMI is 27 kg/m2. Physical examination shows dry skin and a slightly distended abdomen. She has delayed tendon reflex relaxation in the lower extremities. There is 2+ non-pitting edema in the bilateral lower extremities. Which of the following is the most likely cause of this patient’s edema?  

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