scholarly journals Clinical Manifestation of Subacute Thyroiditis Triggered by SARS-CoV-2 Infection Can Be HLA-Dependent

Viruses ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2447
Author(s):  
Magdalena Stasiak ◽  
Katarzyna Zawadzka-Starczewska ◽  
Andrzej Lewiński
Keyword(s):  
Clinical Manifestation ◽  
Clinical Course ◽  
Time Lag ◽  
Subacute Thyroiditis ◽  
Simultaneous Occurrence ◽  
Simultaneous Presence ◽  
Risk Of Recurrence ◽  
Unusual Phenomenon

In the last two years, we have been struggling with the pandemic of SARS-CoV-2, the virus causing COVID-19. Several cases of subacute thyroiditis (SAT) have already been described as directly related to SARS-CoV-2 infection. The clinical course of SAT induced by SARS-CoV-2 can be entirely different from the classic SAT course, and one of the most important differences is a very rapid SAT onset observed in some patients, especially a phenomenon of the simultaneous presence of both diseases. The aim of this report is to compare HLA profile and clinical course of SAT in four patients, in whom SAT was considered as triggered by COVID-19, with special attention paid to the differences between a patient with rare simultaneous presence of SAT and COVID-19, and patients with longer time lag between the diseases. The unusual phenomenon of simultaneous occurrence of COVID-19 and SAT induced by SARS-CoV-2 infection can be HLA-dependent and related to the presence of homozygosity at HLA-B*35. Additionally, the clinical course of SAT triggered by COVID-19 can be HLA-related in regard to the risk of recurrence, and to a variety of other aspects, including severity of thyrotoxicosis.

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.

Time-Lag Between Symptom Onset and Diagnosis of Subacute Thyroiditis – How to Avoid the Delay of Diagnosis and Unnecessary Overuse of Antibiotics

2019 ◽  
Vol 52 (01) ◽  
pp. 32-38 ◽  
Author(s):  
Magdalena Stasiak ◽  
Renata Michalak ◽  
Bartłomiej Stasiak ◽  
Andrzej Lewiński
Keyword(s):  
Antibiotic Treatment ◽  
Clinical Symptoms ◽  
Time Lag ◽  
Delayed Diagnosis ◽  
Simple Algorithm ◽  
Antibiotic Use ◽  
Treated Group ◽  
Subacute Thyroiditis ◽  
Reactive Protein ◽  
Laboratory Test Results

AbstractClinical symptoms of subacute thyroiditis (SAT) may be misleading and the proper diagnosis is significantly delayed, and many unnecessary therapeutic methods are used, including application of antibiotics. The purpose of the study is to analyze the reasons and frequency of delayed SAT diagnosis and unnecessary antibiotic treatment and to propose a simple algorithm to facilitate the diagnosis and prevent antibiotic abuse. Sixty-four SAT patients were divided into groups depending on the period of time from the first symptoms of SAT to diagnosis and on the unnecessary use of antibiotics. Data from medical history and laboratory test results were analyzed for individual groups to determine the reasons for delayed diagnosis and incorrect treatment. In 73% of patients, the diagnosis was delayed from over two weeks up to six months. Among 62 patients who provided data on antibiotic use, 29 (46.77%) were treated with one or more antibiotics due to SAT symptoms. Fever, preceding infection, increased C-reactive protein (CRP), and WBC were characteristic for the antibiotic treated group. Fever, preceding infection, increased CRP and WBC are typical for both SAT and infection and are the main symptoms leading to misdiagnosis and unnecessary antibiotic treatment in SAT. Thus, in all patients with neck pain or other SAT-like symptoms, thorough clinical examination of the neck is mandatory. When firm and/or tender thyroid nodule/goitre is present and erythrocyte sedimentation rate /CRP is increased, patient should be promptly referred to an endocrinologist, and antibiotics are not recommended.

Female Patient with Simultaneous Occurrence of Subacute Thyroiditis and Focal Autonomy

2019 ◽  
Vol 58 (05) ◽  
pp. 401-402
Author(s):  
Christina Loberg ◽  
Dirk Mallek ◽  
Felix M. Mottaghy ◽  
Mohsen Beheshti ◽  
Alexander Heinzel
Keyword(s):  
Emergency Department ◽  
Sore Throat ◽  
Female Patient ◽  
Clinical Presentation ◽  
Subacute Thyroiditis ◽  
Simultaneous Occurrence ◽  
Severe Diarrhea ◽  
Loss Of Appetite

Clinical presentationA 57-year-old female patient presented at the emergency department with fatigue, increased sweating, flushing symptoms, loss of appetite, drowsiness and severe diarrhea. Besides she also mentioned painful left-sided sore throat radiating to the temples, beginning two weeks after a flu and subfebrile temperatures.

Time-lag between symptom onset and laboratory findings in patients with subacute thyroiditis

2014 ◽  
Vol 41 (4) ◽  
pp. 369-372 ◽  
Author(s):  
Tomoyasu Tachibana ◽  
Yorihisa Orita ◽  
Yuya Ogawara ◽  
Yuko Matsuyama ◽  
Iku Abe ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Time Lag ◽  
Subacute Thyroiditis ◽  
Laboratory Findings

SUBACUTE THYROIDITIS

1976 ◽  
Vol 81 (3) ◽  
pp. 707-715 ◽  
Author(s):  
E. G. Lebacq ◽  
G. Therasse ◽  
A. Schmitz ◽  
A. Delannoy ◽  
C. Destailleurs
Keyword(s):  
Thyroid Gland ◽  
Clinical Course ◽  
Subacute Thyroiditis ◽  
Histopathological Study ◽  
Radioiodine Uptake ◽  
Complete Destruction ◽  
Trh Stimulation ◽  
Before And After ◽  
Classical Pattern ◽  
Tsh Levels

ABSTRACT Eleven cases are reported of subacute thyroiditis with histopathological study; there were 9 females and 2 males. Bacteriological studies were inconclusive. Different stages of pathological involvement were observed at the same time in all patients. The clinical course followed the classical pattern in most cases: hyperthyroid-like, hypothyroid-like phase and recovery. Blood TSH assessment before and after TRH stimulation revealed an early phase of depression unresponsive to TRH, followed by high levels with marked stimulation; during the first phase, radioiodine uptake was low, but was enhanced by exogenous TSH administration; accordingly the low uptake seems to be due to low TSH levels and not to complete destruction of the thyroid gland. Failure of TSH levels to rise after TRH stimulation is typical of this stage of the disease. Although the final outcome is not yet predictable in some patients, definitive myxoedema appears to be probable in two cases.

Chapter 7: TBE in special situations

2020 ◽  
Keyword(s):  
Clinical Manifestation ◽  
Environmental Conditions ◽  
Clinical Course ◽  
Milk Products ◽  
Related Disease ◽  
Transplant Patients ◽  
Imported Cases ◽  
Fatal Course ◽  
Transplacental Infection ◽  
In Pregnancy

TBE often takes a severe clinical course in immuno-suppressed patients. In transplant patients TBE usually takes a fatal course. TBE vaccination in immuno-suppressed patients can be non-effective TBE in pregnancy has rarely been reported; from recent cases there is no evidence of transplacental infection of the offspring. The alimentary route of infection of TBE is still common in some European countries resulting in a high clinical manifestation index. TBEV can be infectious in milk and milk products for up to 14 days under optimal environmental conditions. TBE is an important travel-related disease. Increasing numbers of non-endemic countries report imported cases. Imported TBE cases in non-endemic areas pose challenges regarding the diagnosis of TBE.

scholarly journals Kümmell’s Disease: Clarifying the Mechanisms and Patients’ Inclusion Criteria

2014 ◽  
Vol 8 (1) ◽  
pp. 288-297 ◽  
Author(s):  
Charalampos Matzaroglou ◽  
Christos S Georgiou ◽  
Andreas Panagopoulos ◽  
Kostantinos Assimakopoulos ◽  
Hans J Wilke ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Clinical Course ◽  
Time Lag ◽  
Radiographic Finding ◽  
Inclusion Criteria ◽  
Radiographic Appearance ◽  
Vertebral Osteonecrosis ◽  
Kummell’S Disease ◽  
Initial Description ◽  
Kümmell’S Disease

The three major causes of vertebral body collapse include infection, malignant neoplasia, and trauma and it may be difficult to distinguish between them, particularly in the presence of severe osteoporosis. In 1891, however, Dr Hermann Kümmell, further added another possibility of vertebral body crush; the delayed posttraumatic collapse. As originally described, this rare clinical entity includes patients, who after a trivial trauma and an asymptomatic clinical course they develop a progressive vertebral body collapse and a painful kyphosis. Although more than a century has passed from its initial description, only few cases have been reported in the literature, whereas the main pathologic eliciting event is still under investigation. As a consequence, great controversy exists regarding the discrete features of the clinical course, its radiographic appearance and the histopathological findings. To explain the time lag between the initial trauma and the occurrence of the vertebral collapse, the hypothesis of ischemic necrosis was advanced. Equation of Kümmell’s disease with vertebral osteonecrosis, however, has wrongly led many authors to report cases of Kümmell’s disease, even in the absence of history of spinal trauma. On the other hand, high coincidence of vertebral osteonecrosis and the pathognomonic radiographic finding of intravertebral vacuum cleft, has further added to the confusion. In this review we present an overview of the literature on Kümmell’s disease, focusing on the different proposed eliciting mechanisms. We also highlight controversial subjects on clinical course, diagnosis and treatment of this entity, in an attempt to further clarify patients’ inclusion criteria.

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