ketendoКлиническая и экспериментальная тиреоидологияClinical and experimental thyroidology1995-54722310-3787Endocrinology Research Centre10.14341/ket12753ketendo-12753Research ArticleКлинический случайCase ReportОсобенности диагностики подострого тиреоидита в эпоху пандемии COVID-19Difficulties in diagnosing subacute thyroiditis during COVID-19 pandemichttps://orcid.org/0000-0002-8684-6095ТитоваВ. В.TitovaV. V.

Титова Виктория Викторовна, ассистент  кафедры эндокринологии лечебного факультета

117997, г. Москва, ул. Островитянова, д. 1 

eLibrary SPIN: 7864-2910

Victoria V. Тitova, MD, assistant

1 Ostrovitynova street, 117997 Moscow

eLibrary SPIN: 7864-2910

meteora-vica@mail.ruhttps://orcid.org/0000-0001-6385-540XДемидоваТ. Ю.DemidovaT. Yu.

Демидова Татьяна Юльевна, доктор медицинских наук, профессор, заведующая кафедрой эндокринологии лечебного факультета

Москва

eLibrary SPIN: 7864-2910

Tatiana Yu. Demidova, MD, PhD, professor

Moscow

eLibrary SPIN: 9600-9796

t.y.demidova@gmail.comЧернышеваИ. С.ChernyshevaI. S.

Чернышева Ирина Сергеевна, ординатор кафедры эндокринологии лечебного факультета

Москва

Irina S. Chernysheva, resident

Moscow

4ernyscheva.irina@mail.ruРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation2022130720231842022Copyright © Титова В.В., Демидова Т.Ю., Чернышева И.С., 20232023Титова В.В., Демидова Т.Ю., Чернышева И.С.Titova V.V., Demidova T.Y., Chernysheva I.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.cet-endojournals.ru/jour/article/view/12753

Подострый тиреоидит (ПТ) — это воспалительное заболевание щитовидной железы. Клинические проявления включают боль или дискомфорт в шее, болезненный диффузный зоб и преходящий эпизод гипертиреоза. Мы описываем случай 48-летней женщины, у которой не было симптомов, характерных для ПТ. Результаты анализов соответствовали клиническому диагнозу вторичного гипотиреоза. В анамнезе у пациентки были эпизод бессимптомного течения COVID-19 6 мес назад и боли в области шеи месяц назад. Данный клинический случай демонстрирует важность подробного сбора анамнеза, комплексного обследования и правильной интерпретации полученных лабораторных и инструментальных данных в постановке диагноза.

Subacute thyroiditis is an inflammatory disease of the thyroid gland. Clinical manifestations include pain or discomfort in the neck, a painful diffuse goiter, and a transient episode of hyperthyroidism. We describe the case of a 48-year-old woman who had no symptoms characteristic of subacute thyroiditis. The test results were consistent with a clinical diagnosis of secondary hypothyroidism. The patient had a history of asymptomatic COVID-19 episode 6 months ago and neck pain one month ago. This case demonstrates the importance of a detailed history, comprehensive examination, and correct interpretation of laboratory and instrumental findings in making the diagnosis.

подострый тиреоидиттиреотоксикозвторичный гипотиреозанамнез заболеванияsubacute thyroiditisthyrotoxicosissecondary hypothyroidismanamnesis of the disease (medical history)ReferencesРоссийская ассоциация эндокринологов. Клинические рекомендации. Острые и хронические тиреоидиты (исключая аутоиммунный тиреоидит). М.: Российская ассоциация эндокринологов; 2020.Rossijskaja associacija jendokrinologov. Klinicheskie rekomendacii. Ostrye i hronicheskie tireoidity (iskljuchaja autoimmunnyj tireoidit). Moscow: Rossijskaja associacija jendokrinologov; 2020. (In Russ.).Stasiak M, Lewiński A. New aspects in the pathogenesis and management of subacute thyroiditis. Rev Endocr Metab Disord. 2021;22(4):1027-1039. doi: https://doi.org/10.1007/s11154-021-09648-yStasiak M, Lewiński A. New aspects in the pathogenesis and management of subacute thyroiditis. Rev Endocr Metab Disord. 2021;22(4):1027-1039. doi: https://doi.org/10.1007/s11154-021-09648-yNishihara E, Kudo T, Ito M, et al. Papillary thyroid carcinomas are highly obscured by inflammatory hypoechoic regions caused by subacute thyroiditis: a longitudinal evaluation of 710 patients using ultrasonography. Endocr J. 2020;67(5):569-574. doi: https://doi.org/10.1507/endocrj.EJ19-0597Nishihara E, Kudo T, Ito M, et al. Papillary thyroid carcinomas are highly obscured by inflammatory hypoechoic regions caused by subacute thyroiditis: a longitudinal evaluation of 710 patients using ultrasonography. Endocr J. 2020;67(5):569-574. doi: https://doi.org/10.1507/endocrj.EJ19-0597Gül N, Üzüm AK, Selçukbiricik ÖS, et al. Prevalence of papillary thyroid cancer in subacute thyroiditis patients may be higher than it is presumed: retrospective analysis of 137 patients. Radiol Oncol. 2018;52(3):257-262. doi: https://doi.org/10.2478/raon-2018-0027Gül N, Üzüm AK, Selçukbiricik ÖS, et al. Prevalence of papillary thyroid cancer in subacute thyroiditis patients may be higher than it is presumed: retrospective analysis of 137 patients. Radiol Oncol. 2018;52(3):257-262. doi: https://doi.org/10.2478/raon-2018-0027Stasiak M, Michalak R, Stasiak B, Lewiński A. Time-lag between symptom onset and diagnosis of subacute thyroiditis — how to avoid the delay of diagnosis and unnecessary overuse of antibiotics. Horm Metab Res. 2020;52(01):32-38. doi: https://doi.org/10.1055/a-1033-7524Stasiak M, Michalak R, Stasiak B, Lewiński A. Time-lag between symptom onset and diagnosis of subacute thyroiditis — how to avoid the delay of diagnosis and unnecessary overuse of antibiotics. Horm Metab Res. 2020;52(01):32-38. doi: https://doi.org/10.1055/a-1033-7524European One Health Action Plan against Antimicrobial Resistance (AMR). European Commission 2017 [cited 10.12.2020]. Available from: https://ec.europa.eu/health/amr/sites/amr/files/amr_action_plan_2017_en.pdfEuropean One Health Action Plan against Antimicrobial Resistance (AMR). European Commission 2017 [cited 10.12.2020]. Available from: https://ec.europa.eu/health/amr/sites/amr/files/amr_action_plan_2017_en.pdfPatients with COVID-19 may develop thyroid infection 21.05.2020 [cited 20.10.2020]. Available from: https://www.endocrine.org/newsandadvocacy/newsroom/2020/patientswithcovid19maydevelopthyroidinfectionPatients with COVID-19 may develop thyroid infection 21.05.2020 [cited 20.10.2020]. Available from: https://www.endocrine.org/newsandadvocacy/newsroom/2020/patientswithcovid19maydevelopthyroidinfectionLi M-Y, Li L, Zhang Y, Wang X-S. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty. 2020;9(1):45. doi: https://doi.org/10.1186/s40249-020-00662-xLi M-Y, Li L, Zhang Y, Wang X-S. Expression of the SARS-CoV-2 cell receptor gene ACE2 in a wide variety of human tissues. Infect Dis Poverty. 2020;9(1):45. doi: https://doi.org/10.1186/s40249-020-00662-xMuller I, Cannavaro D, Dazzi D, et al. SARS-CoV-2-related atypical thyroiditis. Lancet Diabetes Endocrinol. 2020;8(9):739-741. doi: https://doi.org/10.1016/S2213-8587(20)30266-7Muller I, Cannavaro D, Dazzi D, et al. SARS-CoV-2-related atypical thyroiditis. Lancet Diabetes Endocrinol. 2020;8(9):739-741. doi: https://doi.org/10.1016/S2213-8587(20)30266-7Lania A, Sandri MT, Cellini M, et al. Thyrotoxicosis in patients with COVID-19: the THYRCOV study. Eur J Endocrinol. 2020;183(4):381-387. doi: https://doi.org/10.1530/EJE-20-0335Lania A, Sandri MT, Cellini M, et al. Thyrotoxicosis in patients with COVID-19: the THYRCOV study. Eur J Endocrinol. 2020;183(4):381-387. doi: https://doi.org/10.1530/EJE-20-0335Ippolito S, Dentali F, Tanda ML. SARS-CoV-2: a potential trigger for subacute thyroiditis? Insights from a case report. J Endocrinol Invest. 2020;43(8):1171-1172. doi: https://doi.org/10.1007/s40618-020-01312-7Ippolito S, Dentali F, Tanda ML. SARS-CoV-2: a potential trigger for subacute thyroiditis? Insights from a case report. J Endocrinol Invest. 2020;43(8):1171-1172. doi: https://doi.org/10.1007/s40618-020-01312-7Caron P. Thyroid disorders and SARS-CoV-2 infection: From pathophysiological mechanism to patient management. Ann Endocrinol (Paris). 2020;81(5):507-510. doi: https://doi.org/10.1016/j.ando.2020.09.001Caron P. Thyroid disorders and SARS-CoV-2 infection: From pathophysiological mechanism to patient management. Ann Endocrinol (Paris). 2020;81(5):507-510. doi: https://doi.org/10.1016/j.ando.2020.09.001Scappaticcio L, Pitoia F, Esposito K, et al. Impact of COVID-19 on the thyroid gland: an update. Rev Endocr Metab Disord. 2021;22(4):803-815. doi: https://doi.org/10.1007/s11154-020-09615-zScappaticcio L, Pitoia F, Esposito K, et al. Impact of COVID-19 on the thyroid gland: an update. Rev Endocr Metab Disord. 2021;22(4):803-815. doi: https://doi.org/10.1007/s11154-020-09615-zStasiak M, Michalak R, Lewinski A. Thyroid primary and metastatic malignant tumours of poor prognosis may mimic subacute thyroiditis - time to change the diagnostic criteria: case reports and a review of the literature. BMC Endocr Disord. 2019;19(1):86. doi: https://doi.org/10.1186/s12902-019-0415-yStasiak M, Michalak R, Lewinski A. Thyroid primary and metastatic malignant tumours of poor prognosis may mimic subacute thyroiditis - time to change the diagnostic criteria: case reports and a review of the literature. BMC Endocr Disord. 2019;19(1):86. doi: https://doi.org/10.1186/s12902-019-0415-y

The authors declare that there are no conflicts of interest present.