scholarly journals Subacute Thyroiditis Associated with COVID-19

2020 ◽  
Vol 2020 ◽  
pp. 1-4 ◽  
Author(s):  
Eugenia Campos-Barrera ◽  
Teresa Alvarez-Cisneros ◽  
Mario Davalos-Fuentes ◽  
Takeshi Usui
Keyword(s):  
Inflammatory Response ◽  
Neck Pain ◽  
Thyroid Function ◽  
Subacute Thyroiditis ◽  
Inflammatory Disorder ◽  
Diffuse Goiter ◽  
Upper Respiratory ◽  
Transient Episode ◽  
Rule Out

Subacute thyroiditis is a self-limiting inflammatory disorder, characterized by neck pain or discomfort, a tender diffuse goiter, and sometimes a transient episode of hyperthyroidism followed by euthyroidism and sometimes hypothyroidism. There is usually a normalization of thyroid function within a few weeks. Subacute thyroiditis has a higher incidence in summer and has been linked to a viral or bacterial upper respiratory postinfection inflammatory response. We hereby describe the case of a previously healthy 37-year-old female presenting with subacute thyroiditis associated with a very mild presentation of COVID-19. As most patients with SARS-Cov-2 are asymptomatic, we suggest to rule out SARS-Cov-2 infection in patients presenting with symptoms suggesting SAT.

scholarly journals Subacute Thyroiditis After Sars-COV-2 Infection

2020 ◽  
Vol 105 (7) ◽  
pp. 2367-2370 ◽  
Author(s):  
Alessandro Brancatella ◽  
Debora Ricci ◽  
Nicola Viola ◽  
Daniele Sgrò ◽  
Ferruccio Santini ◽  
...  
Keyword(s):  
Neck Pain ◽  
Thyroid Function ◽  
Inflammatory Markers ◽  
Clinical Laboratory ◽  
Clinical Manifestations ◽  
Subacute Thyroiditis ◽  
Imaging Features ◽  
Free Triiodothyronine ◽  
First Case ◽  
Oropharyngeal Swab

Abstract Context Subacute thyroiditis (SAT) is a thyroid disease of viral or postviral origin. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has spread rapidly worldwide and Italy has been severely affected by this outbreak. Objectives The objective of this work is to report the first case of SAT related to SARS-CoV-2 infection. Methods We describe the clinical, laboratory, and imaging features of an 18-year-old woman who came to our attention for fever, neck pain radiated to the jaw, and palpitations occurring 15 days after a SARS-CoV-2–positive oropharyngeal swab. Coronavirus disease 2019 (COVID-19) had been mild and the patient had completely recovered in a few days. Results At physical examination the patient presented with a slightly increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams free thyroxine and free triiodothyronine were high, thyrotropin undetectable, and inflammatory markers and white blood cell count elevated. Bilateral and diffuse hypoechoic areas were detected at neck ultrasound. One month earlier, thyroid function and imaging both were normal. We diagnosed SAT and the patient started prednisone. Neck pain and fever recovered within 2 days and the remaining symptoms within 1 week. Thyroid function and inflammatory markers normalized in 40 days. Conclusions We report the first case of SAT after a SARS-CoV-2 infection. We alert clinicians to additional and unreported clinical manifestations associated with COVID-19.

scholarly journals Clinical characteristics of patients with subacute thyroidits and factors affecting development hypothyroidism after subacute thyroiditis

2022 ◽  
Author(s):  
İNAN ANAFOROĞLU ◽  
Murat Topbas
Keyword(s):  
Neck Pain ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Subacute Thyroiditis ◽  
Upper Respiratory Tract ◽  
Inclusion Criteria ◽  
Imaging Studies ◽  
Factors Affecting ◽  
Upper Respiratory

IntroductionSubacute thyroiditis (SAT) is typically a self-limiting, inflammatory disease. Patients can experience hypothyroidism during or after an episode. We examined the clinical characteristics based on laboratory and imaging studies in patients with SAT and possible factors contributing to the development of permanent hypothyroidism after SAT.Material and methodsWe retrospectively examined medical records of patients diagnosed with SAT at one medical facility in Turkey. Patients known to have previous thyroid disease, those with <6 months of follow-up after resolution of SAT, and those who lacked sufficient data for analysis were excluded. Of the 283 patients identified 119 met all inclusion criteria. We extracted data on demographics, laboratory tests, neck pain and other symptoms, ultrasonography findings, medication use, and SAT recurrence. We examined the relationships between these variables and development of permanent hypothyroidism.ResultsThe patients were 42 years old on average, and 78% were women. Most patients (70%) described flu-like symptoms before neck pain started; accordingly, 57% had initially visited a specialty other than endocrinology before SAT was diagnosed, and 28% had received antibiotics for misdiagnosed upper respiratory tract infection. In all, 10 patients (8.4%) developed permanent hypothyroidism after SAT. These patients had received steroids significantly longer than did those without permanent hypothyroidism (mean 17.7 vs. 8.9 weeks; P = .021). Development of hypothyroidism was significantly lower among patients with thyrotoxicosis.ConclusionsThe diagnosis of SAT can be challenging. Patients who require longer-term steroids after SAT and who have recurrent SAT should be closely monitored for development of hypothyroidism.

scholarly journals SUBACUTE THYROIDITIS IN A PATIENT WITH CORONAVIRUS DISEASE 2019

2020 ◽  
Vol 6 (6) ◽  
pp. e361-e364
Author(s):  
Mari Des J. San Juan ◽  
Mary Queen V. Florencio ◽  
Mark Henry Joven
Keyword(s):  
Neck Pain ◽  
Thyroid Function ◽  
Reference Range ◽  
Thyroid Stimulating Hormone ◽  
Subacute Thyroiditis ◽  
Thyroid Function Tests ◽  
Anterior Neck ◽  
Neck Ultrasound ◽  
Function Tests ◽  
Stimulating Hormone

Objective: Subacute thyroiditis (SAT) is an inflammatory disorder of the thyroid gland that causes destructive thyrotoxicosis and is attributed to a viral or post-viral response. SARS-CoV-2 is a novel coronavirus that caused a global pandemic in 2020. We present a case that suggests that there may be a relationship between SAT and corona-virus disease 2019 (COVID-19). Methods: We describe the clinical findings, thyroid function tests, and neck ultrasound of a patient presenting with anterior neck pain. Results: A 47-year-old, Filipino female presented with anterior neck pain associated with neck tenderness and goiter. She did not have fever or respiratory symptoms but had right lower lobe pneumonia on chest radiograph. Thyroid function tests were consistent with subclinical hyperthyroidism with thyroid-stimulating hormone of 0.05 μIU/mL (reference range is 0.47 to 4.68 μIU/mL), free thyroxine of 1.68 pg/mL (reference range is 0.78 to 2.19 pg/mL), and total triiodothyronine of 1.4 ng/mL (reference range is 0.97 to 1.69 ng/mL). Anti-thyroid peroxidase, anti-thyroglobulin, and thyroid-stimulating hormone receptor antibodies were negative. Neck ultrasound showed heterogenous thyroid tissues with normal vascularity. Reverse transcription-polymerase chain reaction for SARS-CoV-2 using nasopharyngeal and oropharyngeal swabs were positive. The patient was diagnosed as having SAT and was treated with mefenamic acid, which was later switched to celecoxib. Ceftriaxone and hydroxychloroquine were started for COVID-19 pneumonia. Complete resolution of symptoms and primary hypothyroidism occurred after 2 months. Conclusion: SAT may be a presenting symptom or a sequela of COVID-19. Histopathology studies and definitive documentation of the virus in thyroid tissues may be required to confirm the relationship between SAT and COVID-19.

scholarly journals Subacute thyroiditis associated with COVID-19

2020 ◽  
Vol 13 (8) ◽  
pp. e237336 ◽  
Author(s):  
Shaikh Abdul Matin Mattar ◽  
Samuel Ji Quan Koh ◽  
Suresh Rama Chandran ◽  
Benjamin Pei Zhi Cherng
Keyword(s):  
Differential Diagnosis ◽  
Neck Pain ◽  
Thyroid Function ◽  
Subacute Thyroiditis ◽  
Thyroid Function Tests ◽  
Anterior Neck ◽  
Clinical Resolution ◽  
Function Tests ◽  
Hospitalised Patient

We report a case of a hospitalised patient with COVID-19 who developed subacute thyroiditis in association with SARS-COV-2 infection. The patient presented with tachycardia, anterior neck pain and thyroid function tests revealing hyperthyroidism together with consistent ultrasonographic evidence suggesting subacute thyroiditis. Treatment with corticosteroids resulted in rapid clinical resolution. This case illustrates that subacute thyroiditis associated with viruses such as SARS-CoV-2 should be recognised as a complication of COVID-19 and considered as a differential diagnosis when infected patients present with tachycardia without evidence of progression of COVID-19 illness.

SUBACUTE THYROIDITIS

1960 ◽  
Vol XXXIII (III) ◽  
pp. 457-472 ◽  
Author(s):  
B.-A. Lamberg ◽  
G. Hintze ◽  
R. Jussila ◽  
M. Berlin
Keyword(s):  
Thyroid Function ◽  
Early Phase ◽  
Radioactive Iodine ◽  
Serum Proteins ◽  
Conversion Ratio ◽  
Subacute Thyroiditis ◽  
Synthetic Analogues ◽  
The Third ◽  
Thyroid Uptake ◽  
Iodine Metabolism

ABSTRACT A series of cases of clinically diagnosed subacute thyroiditis comprising 11 patients is reported. Studies on the iodine metabolism, electrophoretic distribution of the serum proteins and the responsiveness to TSH were carried out. The patients were observed for periods up to 16 months from the onset of the disease. In the early phase there was an elevation of the serum PBI in a few cases and hyperthyroid signs in some, accompanied by depressed thyroid uptake of radioactive iodine and a fairly good response to TSH. Later, the thyroid grew hard and the iodine metabolism changed. In several cases there was a marked increase in the conversion ratio and the serum PB131I level. The responses to TSH was variable for different parameters of thyroid function, suggesting a state of »low thyroid reserve« as defined by Jefferies et al. (1956). Hypothyroidism developed in 3 cases; in two of them there was a response to exogenous TSH, in the third no response was seen at this stage of the disease. Cortisone and synthetic analogues seem to be of great benefit in the treatment of the acute symptoms of the disease.

Relationship Between Gamma-glutamyl Transpeptidase Activity and Inflammatory Response in Lichen Planus

2018 ◽  
Vol 69 (3) ◽  
pp. 739-743 ◽  
Author(s):  
Madalina Irina Mitran ◽  
Ilinca Nicolae ◽  
Corina Daniela Ene ◽  
Cristina Iulia Mitran ◽  
Clara Matei ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Lichen Planus ◽  
Inflammatory Process ◽  
Molecular Mechanisms ◽  
Functional Adaptation ◽  
Physical Factors ◽  
Inflammatory Disorder ◽  
Gamma Glutamyl Transpeptidase ◽  
Gamma Glutamyl ◽  
Glutamyl Transpeptidase

Chemicals used in the manufacture of synthetic fibers have been associated with undesirable side effects such as itching or skin lesions and it seems that they are involved in the induction of pathological processes such as oxidative stress and inflammation. Lichen planus (LP) can be regarded as an inflammatory disorder, chemical and physical factors playing an important role in the perpetuation of the inflammatory process. Gamma-glutamyl transpeptidase (GGT) plays an important role in the preservation of skin architecture and modulation of skin inflammation. In this study, we found that GGT activity is increased in LP patients with mild inflammation, whilst GGT is inactivated under conditions of severe inflammation. Therefore, GGT is involved in the inflammatory process, but there is no a positive correlation between its activity and the intensity of the inflammatory response. This functional adaptation of the enzyme may be due to down-regulation of its synthesis under free radical overload conditions. Understanding the molecular mechanisms involved in the modulation of intracellular redox homeostasis is an important step in the pharmacological management of patients with LP.

scholarly journals Case Report: De Quervain’s Thyroiditis as a Long-Term Sequelae Complication to SARS-CoV-2 Infection

2021 ◽  
pp. 64-70
Author(s):  
Mark Kong ◽  
Sarah La Porte
Keyword(s):  
Case Report ◽  
Thyroid Function ◽  
Elevated Serum ◽  
Subacute Thyroiditis ◽  
Thyroid Function Tests ◽  
Thyroid Function Testing ◽  
Neck Lump ◽  
Function Testing

A 44-year-old man presented with an enlarged painful lower anterior neck lump with elevated serum concentrations of free thyroxine (T4) and tri-iodothyronine (T3), alongside the presence of antithyroid peroxidase antibodies. Prior to presentation, the patient was demonstrating recovery from a SARS-CoV-2 infection that required sedation, intubation, and invasive ventilation in the intensive care unit (ICU) for 11 days. Ultrasound examination of the thyroid demonstrated features of De Quervain’s (subacute) thyroiditis. This corresponded to the clinical picture, and continuous thyroid function tests were arranged. Emerging evidence throughout the SARS-CoV-2 pandemic describes the long-term sequelae of the infection, including developing atypical effects on the thyroid gland. This case report emphasises the association of painful subacute thyroiditis with post-viral infection and its manifestation during recovery from severe SARS-CoV-2, suggesting that follow-up thyroid function testing should be considered in patients discharged from the ICU who develop neck discomfort.

scholarly journals De Quervain’s thyroiditis: current concepts and a report of four cases

2013 ◽  
pp. 49-54
Author(s):  
Roberto Boni ◽  
Pier G. Rabitti
Keyword(s):  
Post Partum ◽  
Rare Complication ◽  
Treatment Options ◽  
Current Treatment ◽  
Subacute Thyroiditis ◽  
Literature Discussion ◽  
Inflammatory Disorder ◽  
Upper Respiratory Tract ◽  
Systemic Symptoms ◽  
End Stage

Introduction: De Quervain’s subacute thyroiditis is a self-limiting granulomatous inflammatory disorder, which is thought to be virally induced in genetically predisposed individuals. It is characterized by thyroid pain and thyrotoxicosis, as well as by systemic symptoms like fever, hepatic cytolysis, and an elevated erythrocyte sedimentation rate. It is often mistaken for an upper respiratory tract infection. Materials and methods: The authors review recent advances in the understanding of the pathogenesis and pathophysiology of De Quervain’s subacute thyroiditis; risk factors for complications, with emphasis on relapses and end-stage hypothyroidism; differential diagnosis and the exclusion of other subtypes of thyroiditis; and current treatment options. Four cases of De Quervain’s thyroiditis are then analyzed and compared with cases in the literature. Discussion: In three of the patients, onset occurred in June and was probably related to a small, seasonal epidemic cluster. These cases were quite different from the fourth one, which occurred in October, suggesting that two distinct viruses might be involved. One of the patients presented a very rare complication, vocal-cord paralysis, which responded well to glucocorticoid therapy. Another presented with an even rarer post-partum form of painful thyroiditis.

scholarly journals A Case of Thyrotoxicosis due to Simultaneous Occurrence of Subacute Thyroiditis and Graves’ Disease

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Kazunori Kageyama ◽  
Noriko Kinoshita ◽  
Makoto Daimon
Keyword(s):  
Thyroid Hormones ◽  
Thyroid Disease ◽  
Rare Case ◽  
Autoimmune Thyroid Disease ◽  
Subacute Thyroiditis ◽  
Simultaneous Occurrence ◽  
Graves Disease ◽  
Inflammatory Disorder ◽  
Autoimmune Thyroid ◽  
Prompt Diagnosis

Subacute thyroiditis is an inflammatory disorder of the thyroid. Graves’ disease is an autoimmune thyroid disease in which thyroid hormones are overproduced. Here we present a rare case of thyrotoxicosis due to the simultaneous occurrence of both diseases. Prompt diagnosis and therapy are required to prevent complications in patients with thyrotoxicosis.

scholarly journals Zdhhc2 Is Essential for Plasmacytoid Dendritic Cells Mediated Inflammatory Response in Psoriasis

2021 ◽  
Vol 11 ◽  
Author(s):  
Binhui Zhou ◽  
Wenyi Yang ◽  
Wushan Li ◽  
Le He ◽  
Liaoxun Lu ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Plasmacytoid Dendritic Cell ◽  
White Blood Cells ◽  
Psoriatic Skin ◽  
Interferon Α ◽  
Inflammatory Disorder ◽  
Post Translational Modification ◽  
Cellular Components ◽  
Deficient Mice

Zdhhc family genes are composed of 24 members that regulate palmitoylation, a post-translational modification process for proteins. Mutations in genes that alter palmitoylation or de-palmitoylation could result in neurodegenerative diseases and inflammatory disorders. In this study, we found that Zdhhc2 was robustly induced in psoriatic skin and loss of Zdhhc2 in mice by CRISPR/Cas9 dramatically inhibited pathology of the ear skin following imiquimod treatment. As psoriasis is an inflammatory disorder, we analyzed tissue infiltrating immune cells and cytokine production. Strikingly we found that a master psoriatic cytokine interferon-α (IFN-α) in the lesioned skin of wildtype (WT) mice was 23-fold higher than that in Zdhhc2 deficient counterparts. In addition, we found that CD45+ white blood cells (WBC) infiltrating in the skin of Zdhhc2 deficient mice were also significantly reduced. Amelioration in psoriasis and dramatically reduced inflammation of Zdhhc2 deficient mice led us to analyze the cellular components that were affected by loss of Zdhhc2. We found that imiquimod induced plasmacytoid dendritic cell (pDC) accumulation in psoriatic skin, spleen, and draining lymph nodes (DLN) were drastically decreased in Zdhhc2 deficient mice, and the expression of pDC activation marker CD80 also exhibited significantly inhibited in psoriatic skin. In further experiments, we confirmed the cell intrinsic effect of Zdhhc2 on pDCs as we found that loss of zDHHC2 in human CAL-1 pDC dampened both interferon regulatory factor 7 (IRF7) phosphorylation and IFN-α production. Therefore, we identified novel function of Zdhhc2 in controlling inflammatory response in psoriasis in mice and we also confirmed that crucial role of Zdhhc2 in pDCs by regulating IRF7 activity and production of the critical cytokine. Our results finding the dependence of IFN-α production on Zdhhc2 in inflamed murine skin and in human pDCs provide rationale for targeting this new molecule in treatment of inflammation.

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