Subacute Thyroiditis Post-COVID-19 Infection: A Case Report

Abdelgalil       Ragab

doi:10.2174/03666211216095920

Abstract

Background: Subacute thyroiditis (SAT) or granulomatous thyroiditis is usually a self-limiting inflammatory condition. The clinical presentation varies from person to person, but is usually associated with pain and systemic symptoms.

Case Report: Herein, a case of a previously healthy 40 years old male who presented with unilateral right neck pain of gradual onset and progressive course has been described. The patient had recovered from a symptomatic Covid-19 infection 5 months back. The clinical examination, imaging and histopathological examination were consistent with the clinical diagnosis of subacute thyroiditis. The patient received medication in the form of pain killer, Celebrex and paracetamol, without corticosteroids, and completely recovered.

Conclusion: The possibility of subacute thyroiditis post-COVID-19 infection should be considered.

Keywords: COVID-19, Subacute thyroiditis, De Quervain thyroiditis, Neck pain, Celebrex, Paracetamol.

[1] 
Czerwonka L. Thyroiditis. In: Docimo Jr S, Pauli E, Eds. Clinical algorithms in general surgery. Springer 2019.
[2] 
Intenzo CM, Park CH, Kim SM, Capuzzi DM, Cohen SN, Green P. Clinical, laboratory, and scintigraphic manifestations of subacute and chronic thyroiditis. Clin Nucl Med  1993; 18(4): 302-6.
[http://dx.doi.org/10.1097/00003072-199304000-00007] [PMID: 8386991] 
[3] 
Cappelli C, Pirola I, Gandossi E, Formenti AM, Agosti B, Castellano M. Ultrasound findings of subacute thyroiditis: a single institution retrospective review. Acta Radiol  2014; 55(4): 429-33.
[http://dx.doi.org/10.1177/0284185113498721] [PMID: 23969266] 
[4] 
Mehmood MA, Bapna M, Arshad M. A case of post-COVID-19 subacute thyroiditis. Cureus  2020; 12(12): e12301.
[http://dx.doi.org/10.7759/cureus.12301] [PMID: 33510992] 
[5] 
Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res  2020; 24: 91-8.
[http://dx.doi.org/10.1016/j.jare.2020.03.005] [PMID: 32257431] 
[6] 
Huang C, Wang Y, Li X, Ren L, Zhao Jianping, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet  2020; 395(20): 497-506.
[7] 
Brouqui P, Raoult D, Conte-Devolx B. Coxsackie thyroiditis. Ann Intern Med  1991; 114(12): 1063-4.
[http://dx.doi.org/10.7326/0003-4819-114-12-1063_2] [PMID: 1851403] 
[8] 
Chong WH, Shkolnik B, Saha B, Beegle S. Subacute thyroiditis in the setting of coronavirus disease 2019. Am J Med Sci 2020. Epub ahead of print
[http://dx.doi.org/10.1016/j.amjms.2020.09.011] [PMID: 33097194] 
[9] 
Fatourechi V, Aniszewski JP, Fatourechi GZ, Atkinson EJ, Jacobsen SJ. Clinical features and outcome of subacute thyroiditis in an incidence cohort: Olmsted County, Minnesota, study. J Clin Endocrinol Metab  2003; 88(5): 2100-5.
[http://dx.doi.org/10.1210/jc.2002-021799] [PMID: 12727961] 
[10] 
Muller I, Cannavaro D, Dazzi D, et al. SARS-CoV-2-related atypical thyroiditis. Lancet Diabetes Endocrinol  2020; 8(9): 739-41.
[http://dx.doi.org/10.1016/S2213-8587(20)30266-7] [PMID: 32738929] 
[11] 
Campos-Barrera E, Alvarez-Cisneros T, Davalos-Fuentes M. Subacute thyroiditis associated with COVID-19. Case Rep Endocrinol  2020; 2020: 8891539.
[http://dx.doi.org/10.1155/2020/8891539] [PMID: 33005461] 
[12] 
Wiley. "New insights on inflammation in COVID-19." ScienceDaily. 2021.  Available from: 
                    www.sciencedaily.com/releases/2021/04/2104
                        21082906.htm
[13] 
Kessel C, Vollenberg R, Masjosthusmann K, et al. Discrimination of COVID-19 from inflammation-induced cytokine storm syndromes by disease-related blood biomarkers. Arthritis Rheumatol  2021; 73(10): 1791-9.
[http://dx.doi.org/10.1002/art.41763] [PMID: 33880885] 
[14] 
Cheng MH, Zhang S, Porritt RA, et al. Superantigenic character of an insert unique to SARS-CoV-2 spike supported by skewed TCR repertoire in patients with hyperinflammation Proceedings of the National Academy of Sciences. 
[http://dx.doi.org/10.1073/pnas.2010722117] 