患者，女，35岁。长期值夜班，日夜颠倒，近期出现怕热多汗、烦躁易怒、心悸失眠等症，自觉甲状腺肿大，看镜子未见肿大，遂至医院就诊，查体可扪及肿大甲状腺，査甲状腺功能见TSH下降，T3、T4升高。该患者最可能的诊断为

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