During a clinic office visit, a 35-year-old male stockbroker shows signs of excessive nervousness and irritability and complains that the office is too hot. History and physical examination reveals the presence of a goiter and exophthalmia. Laboratory analysis of his blood reveals high antibody titers against the thyroid-stimulating hormone (TSH) receptor. Which of the following is the most likely diagnosis?

Loss of tolerance by the immune system to certain self-components can lead to the formation of antibodies, causing tissue and organ damage. Such diseases are referred to as autoimmune diseases. There are a host of autoimmune diseases characterized by the auto anti-bodies. The presence of a "butterfly" rash is a classic cutaneous sign of SLE and is characterized by a rash over the bridge of the nose and on the cheeks.ABO BLOOD GROUPSGroupAntigen on Red CellAntibody in PlasmaAAAnti-BBBAnti-AABA and BNo anti-A or anti-BONo A or BAnti-A and anti-B COMPATIBILITY OF BLOOD TRANSFUSIONS BETWEEN ABO BLOOD GROUPSa RecipientDonorOABABOYesYesYesYesA (AA or AO)NoYesNoYesB (BB or BO)NoNoYesYesABNoNoNoYes a"Yes" indicates that a blood transfusion from a donor with that the blood group to a recipient with that blood group is compatible, that is, no hemolysis will occur. "No" indicates that the transfusion is incompatible and that hemolysis of the donor's cells will occur.