Purpose

Subacute thyroiditis (SAT) is an inflammatory thyroid disorder of viral origin, generally preceded by an upper respiratory tract infection. Since the disorder is self-limiting, it is frequently underdiagnosed. However, the disease should not be overlooked since the associated thyrotoxicosis may worsen the clinical course of concomitant disorders (e.g., respiratory distress) and long-term sequelae, such as autoimmune hypothyroidism, have been reported.

Methods

Here we describe a woman who developed SAT with thyrotoxicosis after SARS-COV-2 infection. Coronavirus disease (COVID-19) symptoms were mild and the patient was managed with no specific treatment and recovered rapidly.

Results

Six weeks after the onset of the upper respiratory tract infection, the patient developed pain and tenderness in the anterior cervical region, fatigue, tremors, and palpitations. Physical examination revealed mild tremors of the extremities, a diffuse and painful goiter, and enlarged and tender cervical and submandibular lymph nodes. At biochemical evaluation, TSH was suppressed, FT3 and FT4 were high, and serum thyroglobulin was markedly increased (188 pg/mL; n.v. 0–40). Thyroid scintigraphy showed markedly reduced ^99mTc-perthecnetate uptake in the gland. All findings were consistent with SAT, and treatment with oral prednisone (25 mg/day as the starting dose, gradually tapered) was started. Under the corticosteroid therapy, there was progressive resolution of symptoms and signs, and, within 4 weeks, all thyroid functional tests and inflammatory indexes normalized.

Conclusion

Clinicians should be aware of thyroid manifestations potentially associated with COVID-19.

中文翻译：

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感染SARS-COV-2的患者的亚急性甲状腺炎：与COVID-19大流行相关的内分泌并发症。

目的

亚急性甲状腺炎（SAT）是一种由病毒引起的炎性甲状腺疾病，通常在上呼吸道感染之前发生。由于这种疾病是自限性的，因此常常被诊断不足。然而，该疾病不容忽视，因为相关的甲状腺毒症可能使伴随疾病（例如呼吸窘迫）和长期后遗症（例如自身免疫性甲状腺功能减退症）的临床病情恶化。

方法

在这里，我们描述了一名在SARS-COV-2感染后发展为伴有甲状腺毒症的SAT患者。冠状病毒病（COVID-19）症状较轻，患者未经特殊治疗即可康复，并迅速康复。

结果

上呼吸道感染发作后六周，患者在前颈区出现疼痛和压痛，疲劳，震颤和心。体格检查发现四肢轻度震颤，甲状腺肿大且疼痛，宫颈和下颌下淋巴结肿大和触痛。在生化评估中，TSH受到抑制，FT3和FT4高，血清甲状腺球蛋白显着增加（188 pg / mL； nv 0-40）。甲状腺闪烁显像减少^99mTc-过碳酸盐在腺体的摄取。所有发现均与SAT一致，并开始使用口服泼尼松治疗（25 mg /天为起始剂量，逐渐逐渐减少）。在皮质类固醇治疗下，症状和体征逐渐得到缓解，并且在4周内，所有甲状腺功能检查和炎症指标均恢复正常。

结论

临床医生应注意可能与COVID-19相关的甲状腺表现。