Painless thyroiditis in SARS-CoV-2 infection

Millán, Rebeca Barahona San; Daura, Marina Tantinyà; Ganoza, Abelardo Hurtado; Sala, Monica

doi:10.1016/j.endien.2021.11.030

Cited by 5 publications

(6 citation statements)

References 3 publications

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“…One possible speculation is that painless thyroiditis may be overlooked because of its mild symptoms. Indeed, our patient and the previously reported case3 were asymptomatic and were diagnosed incidentally by blood tests.…”

Section: Discussionsupporting

confidence: 54%

“…Thyroid scintigraphy showed a marked decrease in thyroid gland uptake, and he was diagnosed with painless thyroiditis. On follow-up medical examination, thyroid function normalised without any specific medication 3. In the other case, a woman in her 20s was reported to be diagnosed with postpartum thyroiditis following SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 98%

“…On follow-up medical examination, thyroid function normalised without any specific medication. 3 In the other case, a woman in her 20s was reported to be diagnosed with postpartum thyroiditis following SARS-CoV-2 infection. She had a history of painless thyroiditis with a background of Hashimoto's thyroiditis and was infected…”

Section: Discussionmentioning

confidence: 99%

“…Recently, two cases of painless thyroiditis and postpartum thyroiditis diagnosed after SARS-CoV-2 infection have been reported 3 4. A man in his 50s admitted to the hospital for treatment of COVID-19 was incidentally found to have thyrotoxicosis in a blood test on admission.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, there have been reports on subacute thyroiditis, Graves’ disease and Hashimoto’s thyroiditis following SARS-CoV-2 infection 1 2. However, few studies have reported painless thyroiditis or postpartum thyroiditis diagnosed after SARS-CoV-2 infection 3 4. To the best of our knowledge, no case of histologically confirmed painless thyroiditis following SARS-CoV-2 infection has been reported.…”

Section: Introductionmentioning

confidence: 89%

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Painless thyroiditis incidentally diagnosed following SARS-CoV-2 infection

et al. 2022

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A euthyroid woman in her 50s with papillary thyroid cancer and primary hyperparathyroidism was referred to our hospital for surgery. Her surgery was scheduled for 4 months later but was postponed because she was diagnosed with COVID-19. Five months after the first visit, she was admitted to our hospital to undergo the planned thyroid lobectomy and parathyroidectomy. Her blood tests on admission showed thyrotoxicosis, with negative thyroid-stimulating hormone receptor and thyroid-stimulating antibody. Notably, her anti-thyroglobulin antibody and anti-thyroid peroxidase antibody, which were originally negative, became positive after SARS-CoV-2 infection. She was diagnosed with painless thyroiditis. Her general condition and vital signs were stable, and the surgery was cautiously performed. Histopathological examination of the resected thyroid revealed papillary thyroid carcinoma, and the findings were consistent with painless thyroiditis. Her postoperative course was uneventful, and her thyroid function improved 2 weeks after the operation.

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 89%

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Painless thyroiditis incidentally diagnosed following SARS-CoV-2 infection

et al. 2022

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Case report of subacute thyroiditis following SARS-CoV-2 infection

Puškarević,

Radmilo,

Vuletić-Stanojević

et al. 2024

Timočki medicinski glasnik

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INTRODUCTION: SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) is a singlestranded RNA virus with an envelope that causes COVID-19 infection. The disease can be accompanied by mild cold-like symptoms, but it can also have potentially severe complications, some of which can be fatal. According to recent data, the virus can also be one of the causes of subacute thyroiditis (SAT). According to available data, the period of symptom manifestation of thyroiditis (SAT) after recovering from Covid-19 infection is 29 days. The disease may pass through stages of hyperthyroidism, hypothyroidism, and then return to a euthyroid state. In 10% of cases, permanent hypothyroidism may occur, requiring levothyroxine therapy. Treatment is usually symptomatic with high doses of aspirin at 600mg 3-4 times a day or nonsteroidal anti-inflammatory drugs. Corticosteroid therapy is introduced in more severe cases. CASE REPORT: A 69-year-old female patient presented to the Covid outpatient clinic complaining of weakness, fatigue, diarrhea, difficulty swallowing, and low-grade fever around 37.5°C. In her personal history, the patient reported being treated for Hashimoto's multinodular goiter with levothyroxine replacement therapy. She tested negative for the SARS-CoV-2 virus with a rapid antigen test and subsequently had a positive PCR test of the nasopharyngeal swab. An antibiotic, cefixime 400mg once daily, was initiated along with other therapy. After three days, her symptoms worsened. She experienced intense pain in the front of the neck, difficulty swallowing, a feeling of a lump in the throat, dry cough, and a body temperature reaching 38.5°C in the evening and at night. On physical examination, a slightly swollen neck was observed, and deeper palpation revealed the thyroid gland as hard and tender. The antibiotic was changed to azithromycin 500mg and ibuprofen 800mg daily. After 15 days, the patient achieved complete clinical recovery, indicating resolution of viral thyroiditis. Hormonal status remained normal throughout, and she was well substituted with levothyroxine. CONCLUSION: General practitioners should be aware of this complication of COVID-19 disease and analyze thyroid hormone levels in their clinics. Due to the population's exposure to the SARS-CoV-2 virus, subacute thyroiditis should be considered in general practice clinics. Suspicion should arise if fever persists, neck pain worsens, and inflammatory markers persist. Laboratory tests, thyroid hormone analysis, and consultation with an endocrinologist or nuclear medicine specialist should be sought as soon as possible.

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Subacute Thyroiditis in Active COVID-19 Infection: A Report of Two Cases With a Systematic Review of the Literature

Ganie,

Rashid,

Qadir

et al. 2024

Cureus

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Subacute thyroiditis (SAT) is a self-limiting inflammatory condition of the thyroid gland with distinct symptoms and a predictable outcome. During the current COVID-19 pandemic, there have been multiple isolated reports of SAT either during the active viral illness or following recovery. Here, we report two such cases of COVID-19 infection presenting with SAT. A 65-year-old male presented with a two-week history of anterior neck pain, odynophagia, high-grade fever (38.9°C), sweating, palpitations, and tremulousness. At physical examination, the patient presented with a slightly increased heart rate and a tender and enlarged thyroid on palpation. Laboratory examination showed high C-reactive protein levels, with elevated erythrocyte sedimentation rate, and thyroid function tests were suggestive of thyrotoxicosis. Ultrasonography showed a heterogeneous thyroid gland with ill-defined hypoechoic areas, and thyroid scintigraphy showed reduced uptake, confirming the diagnosis of SAT. In another case, a 52-year-old male presented with fever, cough, and myalgias, and was diagnosed with mild COVID-19 pneumonia, and managed conservatively. After two weeks, the patient had a recurrence of high-grade fever, odynophagia, palpitations, and tremors. Examination revealed tachycardia, hyperhidrosis, and a tender and enlarged thyroid on palpation. Thyroid function tests revealed low thyroid-stimulating hormone, with normal total T4 and total T3. Ultrasonography examination showed a heterogeneous thyroid gland with bilateral ill-defined hypoechoic areas. In our systematic review, including 103 SAT cases, it has been suggested that SAT should be recognized as an uncommon extra-pulmonary clinical manifestation of COVID-19 infection and clinicians need to be aware of the association. Pending larger multicentric studies, management of the condition has to be on a case-by-case basis.

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Painless thyroiditis in SARS-CoV-2 infection

Cited by 5 publications

References 3 publications

Painless thyroiditis incidentally diagnosed following SARS-CoV-2 infection

Painless thyroiditis incidentally diagnosed following SARS-CoV-2 infection

Case report of subacute thyroiditis following SARS-CoV-2 infection

Subacute Thyroiditis in Active COVID-19 Infection: A Report of Two Cases With a Systematic Review of the Literature

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