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Subacute Thyroiditis Associated with COVID-19: A Case Report

Received: 26 January 2021     Accepted: 17 March 2021     Published: 30 March 2021
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Abstract

Background: Subacute Thyroiditis is a self-limiting thyroidal illness caused by viral infection with clinical course divided into three phases: hyperthyroidism, hypothyroidism followed by euthyroidism. Several viral infections have been linked to be associated with subacute thyroiditis but often no etiology can be found. Objective: The aim of this study is to explore a possible link between subacute thyroiditis and Coronavirus disease (COVID-19) infection. Method: Here we describe a case of subacute thyroiditis which occurred during the recovery phase of initial flu like illness. The initial illness was mild and was treated symptomatically. Later, the patient presented with features of hyperthyroidism and neck pain during recovery of initial flu like illness. Result: Two weeks after the onset of initial illness, the patient presented with neck pain, palpitation, sweating, and weight loss along with mid-line tenderness in neck. Thyroid function test revealed suppressed TSH and elevated free T4 along with reduced uptake on radionuclide thyroid scan. He was treated with NSAIDs and B-blocker which resulted in dramatic improvement in neck pain. Conclusion: Since Subacute thyroiditis is a self limiting disorder, it is often under reported. But It is important to recognize the disorder as it can directly impact on the morbidity and mortality related to other associated primary disorder like respiratory illness. Clinician must be aware about the possibility of thyroiditis in patient developing fever and neck pain and look for it.

Published in International Journal of Diabetes and Endocrinology (Volume 6, Issue 1)
DOI 10.11648/j.ijde.20210601.19
Page(s) 54-57
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Subacute Thyroiditis, COVID-19, SARS-CoV-2, De Quervain’s Thyroiditis

References
[1] Chiaruzzi M, Arcani R, Mazodier K, Jean R, Weiller P-J, Kaplanski G, et al. A Case of Subacute Thyroiditis Associated with Erythrovirus B19 Infection. Am J Med. 2020 Jun 1; 133 (6): e296–7.
[2] Hennessey J v. Subacute Thyroiditis. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000.
[3] Bouillet B, Petit J-M, Piroth L, Duong M, Bourg J-B. A Case of Subacute Thyroiditis Associated with Primary HIV Infection. Am J Med. 2009 Apr 1; 122 (4): e5–6.
[4] Desailloud R, Hober D. Viruses and thyroiditis: an update. Virol J. 2009 Jan 12; 6 (1): 5.
[5] Guan W, Ni Z, Hu Y, Liang W, Ou C, He J, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020 Apr 30; 382 (18): 1708–20.
[6] Mehta OP, Bhandari P, Raut A, Kacimi SEO, Huy NT. Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation. Front Public Health [Internet]. 2021; 8.
[7] Brancatella A, Ricci D, Viola N, Sgrò D, Santini F, Latrofa F. Subacute Thyroiditis After Sars-COV-2 Infection. J Clin Endocrinol Metab [Internet]. 2020 Jul.
[8] Ippolito S, Dentali F, Tanda ML. SARS-CoV-2: a potential trigger for subacute thyroiditis? Insights from a case report. J Endocrinol Invest.
[9] Asfuroglu Kalkan E, Ates I. A case of subacute thyroiditis associated with Covid-19 infection. J Endocrinol Invest [Internet]. 2020 Jun 5.
[10] Ruggeri RM, Campennì A, Siracusa M, Frazzetto G, Gullo D. Subacute thyroiditis in a patient infected with SARS-COV-2: an endocrine complication linked to the COVID-19 pandemic. Hormones. 2021 Mar 1; 20 (1): 219–21.
[11] Siolos A, Terzaki A, Tigas S. Subacute thyroiditis in a patient with Epstein-Barr virus (EBV) meningitis. In BioScientifica; 2018.
[12] Stasiak M, Tymoniuk B, Stasiak B, Lewiński A. The Risk of Recurrence of Subacute Thyroiditis Is HLA-Dependent. Int J Mol Sci [Internet]. 2019 Mar 3.
[13] Duan L, Feng X, Zhang R, Tan X, Xiang X, Shen R, et al. Short-Term Versus 6-Week Prednisone In The Treatment Of Subacute Thyroiditis: A Randomized Controlled Trial. Endocrine Practice. 2020 Aug 1; 26 (8): 900–8.
[14] Sato J, Uchida T, Komiya K, Goto H, Takeno K, Suzuki R, et al. Comparison of the therapeutic effects of prednisolone and nonsteroidal anti-inflammatory drugs in patients with subacute thyroiditis. Endocrine. 2017 Jan 1; 55 (1): 209–14.
[15] Rotondi M, Coperchini F, Ricci G, Denegri M, Croce L, Ngnitejeu ST, et al. Detection of SARS-COV-2 receptor ACE-2 mRNA in thyroid cells: a clue for COVID-19-related subacute thyroiditis. J Endocrinol Invest [Internet]. 2020 Oct 6.
Cite This Article
  • APA Style

    Om Prakash Mehta, Sumit Rauniyar, Muhammad Naeem Afzal, Rakshya Upreti, Shri Kant Kushwaha. (2021). Subacute Thyroiditis Associated with COVID-19: A Case Report. International Journal of Diabetes and Endocrinology, 6(1), 54-57. https://doi.org/10.11648/j.ijde.20210601.19

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    ACS Style

    Om Prakash Mehta; Sumit Rauniyar; Muhammad Naeem Afzal; Rakshya Upreti; Shri Kant Kushwaha. Subacute Thyroiditis Associated with COVID-19: A Case Report. Int. J. Diabetes Endocrinol. 2021, 6(1), 54-57. doi: 10.11648/j.ijde.20210601.19

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    AMA Style

    Om Prakash Mehta, Sumit Rauniyar, Muhammad Naeem Afzal, Rakshya Upreti, Shri Kant Kushwaha. Subacute Thyroiditis Associated with COVID-19: A Case Report. Int J Diabetes Endocrinol. 2021;6(1):54-57. doi: 10.11648/j.ijde.20210601.19

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  • @article{10.11648/j.ijde.20210601.19,
      author = {Om Prakash Mehta and Sumit Rauniyar and Muhammad Naeem Afzal and Rakshya Upreti and Shri Kant Kushwaha},
      title = {Subacute Thyroiditis Associated with COVID-19: A Case Report},
      journal = {International Journal of Diabetes and Endocrinology},
      volume = {6},
      number = {1},
      pages = {54-57},
      doi = {10.11648/j.ijde.20210601.19},
      url = {https://doi.org/10.11648/j.ijde.20210601.19},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20210601.19},
      abstract = {Background: Subacute Thyroiditis is a self-limiting thyroidal illness caused by viral infection with clinical course divided into three phases: hyperthyroidism, hypothyroidism followed by euthyroidism. Several viral infections have been linked to be associated with subacute thyroiditis but often no etiology can be found. Objective: The aim of this study is to explore a possible link between subacute thyroiditis and Coronavirus disease (COVID-19) infection. Method: Here we describe a case of subacute thyroiditis which occurred during the recovery phase of initial flu like illness. The initial illness was mild and was treated symptomatically. Later, the patient presented with features of hyperthyroidism and neck pain during recovery of initial flu like illness. Result: Two weeks after the onset of initial illness, the patient presented with neck pain, palpitation, sweating, and weight loss along with mid-line tenderness in neck. Thyroid function test revealed suppressed TSH and elevated free T4 along with reduced uptake on radionuclide thyroid scan. He was treated with NSAIDs and B-blocker which resulted in dramatic improvement in neck pain. Conclusion: Since Subacute thyroiditis is a self limiting disorder, it is often under reported. But It is important to recognize the disorder as it can directly impact on the morbidity and mortality related to other associated primary disorder like respiratory illness. Clinician must be aware about the possibility of thyroiditis in patient developing fever and neck pain and look for it.},
     year = {2021}
    }
    

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    T1  - Subacute Thyroiditis Associated with COVID-19: A Case Report
    AU  - Om Prakash Mehta
    AU  - Sumit Rauniyar
    AU  - Muhammad Naeem Afzal
    AU  - Rakshya Upreti
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    DO  - 10.11648/j.ijde.20210601.19
    T2  - International Journal of Diabetes and Endocrinology
    JF  - International Journal of Diabetes and Endocrinology
    JO  - International Journal of Diabetes and Endocrinology
    SP  - 54
    EP  - 57
    PB  - Science Publishing Group
    SN  - 2640-1371
    UR  - https://doi.org/10.11648/j.ijde.20210601.19
    AB  - Background: Subacute Thyroiditis is a self-limiting thyroidal illness caused by viral infection with clinical course divided into three phases: hyperthyroidism, hypothyroidism followed by euthyroidism. Several viral infections have been linked to be associated with subacute thyroiditis but often no etiology can be found. Objective: The aim of this study is to explore a possible link between subacute thyroiditis and Coronavirus disease (COVID-19) infection. Method: Here we describe a case of subacute thyroiditis which occurred during the recovery phase of initial flu like illness. The initial illness was mild and was treated symptomatically. Later, the patient presented with features of hyperthyroidism and neck pain during recovery of initial flu like illness. Result: Two weeks after the onset of initial illness, the patient presented with neck pain, palpitation, sweating, and weight loss along with mid-line tenderness in neck. Thyroid function test revealed suppressed TSH and elevated free T4 along with reduced uptake on radionuclide thyroid scan. He was treated with NSAIDs and B-blocker which resulted in dramatic improvement in neck pain. Conclusion: Since Subacute thyroiditis is a self limiting disorder, it is often under reported. But It is important to recognize the disorder as it can directly impact on the morbidity and mortality related to other associated primary disorder like respiratory illness. Clinician must be aware about the possibility of thyroiditis in patient developing fever and neck pain and look for it.
    VL  - 6
    IS  - 1
    ER  - 

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Author Information
  • Department of General Medicine, King Edward Medical University, Lahore, Pakistan

  • Department of General Medicine, King Edward Medical University, Lahore, Pakistan

  • Department of General Medicine, King Edward Medical University, Lahore, Pakistan

  • Department of Obstetrics and Gynecology, Paropakar Maternity and Womens Hospital, Kathmandu, Nepal

  • Department of Pediatrics, Services Institute of Medical Sciences, Lahore, Pakistan

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