Difficulties in diagnosing subacute thyroiditis during COVID-19 pandemic
https://doi.org/10.14341/ket12753
Abstract
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.
About the Authors
V. V. Titova
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Victoria V. Тitova, MD, assistant
1 Ostrovitynova street, 117997 Moscow
eLibrary SPIN: 7864-2910
T. Yu. Demidova
Pirogov Russian National Research Medical University
Russian Federation
Russian Federation
Tatiana Yu. Demidova, MD, PhD, professor
Moscow
eLibrary SPIN: 9600-9796
I. S. Chernysheva
Pirogov Russian National Research Medical University
Russian Federation
Competing Interests:
Russian Federation
Irina S. Chernysheva, resident
Moscow
Competing Interests:
декларирую отсутствие явных и потенциальных конфликтов интересов, связанных с содержанием настоящей статьи
References
1. Rossijskaja associacija jendokrinologov. Klinicheskie rekomendacii. Ostrye i hronicheskie tireoidity (iskljuchaja autoimmunnyj tireoidit). Moscow: Rossijskaja associacija jendokrinologov; 2020. (In Russ.).
2. 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-y
3. Nishihara 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.EJ19-0597
4. Gül 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-2018-0027
5. Stasiak 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-1033-7524
6. European 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.pdf
7. Patients with COVID-19 may develop thyroid infection 21.05.2020 [cited 20.10.2020]. Available from: https://www.endocrine.org/newsandadvocacy/newsroom/2020/patientswithcovid19maydevelopthyroidinfection
8. Li 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-x
9. Muller 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)30266-7
10. Lania 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-20-0335
11. Ippolito 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/s40618-020-01312-7
12. Caron 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.2020.09.001
13. Scappaticcio 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-z
14. Stasiak 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
Review
For citations:
Titova V.V., Demidova T.Yu., Chernysheva I.S. Difficulties in diagnosing subacute thyroiditis during COVID-19 pandemic. Clinical and experimental thyroidology. 2022;18(4):20-22. (In Russ.) https://doi.org/10.14341/ket12753
Views:
333
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
Email this article 
