Subacute thyroiditis presenting as fever of unknown origin

Second Department of Internal Medicine, Red Cross Hospital, Athens, Greece.
International Journal of Clinical Practice (Impact Factor: 2.57). 11/2007; 64(1):97-8. DOI: 10.1111/j.1742-1241.2006.00927.x
Source: PubMed


Subacute thyroiditis is a painful, inflammatory disease of the thyroid gland, probably of viral origin. It is an uncommon but important cause of fever of unknown origin (FUO). We report a case of a 72-year-old man who presented with a 1 month history of fever, headache and weakness, and in whom extensive evaluation only revealed subacute thyroiditis. He was treated with low-dose steroids and became asymptomatic after 2 weeks. In conclusion, when a patient presents with FUO, subacute thyroiditis should be considered as a possible cause even if classic features are absent.

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    • "In the present study, the patients' leading reported symptoms and signs were those related to thyrotoxicosis; this is consistent with other reports for SAT [12]. One patient presented as a case of Fever of Unknown Origin, an unusual presentation that was previously reported in the literature [14, 15]. "
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    ABSTRACT: Few studies have been reported from the Kingdom of Saudi Arabia (SA) to describe the clinical presentation and long term outcomes of subacute thyroiditis (SAT). Our aim was to review the demographic, anthropometric, clinical presentation, laboratory results, treatment, and disease outcome in Riyadh region and to compare those with results from different regions of the Kingdom and different parts of the world. We reviewed the medical files of patients who underwent thyroid uptake scan during an 8-year period in King Khalid University Hospital. Only 25 patients had confirmed diagnosis of thyroiditis. Age and gender distribution were similar to other studies. Most patients presented with palpitation, goiter, and weight change. Elevated thyroid hormones, suppressed thyroid-stimulating hormone, and elevated ESR were reported. Among those, 7 cases of SAT were recorded. β -Blockers were prescribed to 57% and nonsteroidal anti-inflammatory drugs to 29% of SAT. Long follow-up demonstrated that 85.7% of SAT cases recovered, while 14.3% developed permanent hypothyroidism. In conclusion, SAT is uncommon in the central region of SA. Compared to the western region, corticosteroid is not commonly prescribed, and permanent hypothyroidism is not uncommon. A nation-wide epidemiological study to explain these interprovincial differences is warranted.
    Full-text · Article · Apr 2014 · International Journal of Endocrinology
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    • "Giant cell arteritis, systemic vasculitis, SLE, adult-onset Still's disease, acute rheumatic fever, and polymyalgia rheumatica can be mentioned among noninfectious inflammatory causes [4, 5]. Diseases such as subacute thyroiditis, sarcoidosis, ulcerative colitis, cirrhosis, and drug fever can be mentioned among miscellaneous causes of FUO that are not included in the other groups [4, 6, 7]. "
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    ABSTRACT: Fever of unknown origin (FUO) is generally defined as a fever greater than 38.3°C on several occasions during a period longer than 3 weeks for which the etiology behind cannot be diagnosed at the end of at least 1 week hospital stay. Conventional diagnostic methods are still not adequate to reveal underlying reason in approximately 50% of patients with FUO. In patients with certain diagnosis, three major categories are infections, malignancies, and noninfectious inflammatory diseases. Fluoro-18-fluoro-2-deoxy-D-glucose (FDG) is a structural analog of 2-deoxyglucose and accumulates in malignant tissues but also at sites of infection and inflammation. For this reason, FDG PET or PET/CT has great advantage in understanding of underlying pathology in assessment of FUO. However, till today, there are limited studies about the role of FDG PET or PET/CT in evaluation of FUO. In this paper, the impact of FDG PET or PET/CT in the diagnostic work-up of FUO is described by data obtained from literature review.
    Full-text · Article · Mar 2011
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    ABSTRACT: Subacute (de Quervain's) thyroiditis is a rare but important cause of fever of unknown origin. Most cases of subacute thyroiditis are caused by a variety of viruses, for example, Coxsackie, cytomegalovirus, Epstein-Barr virus, and adenovirus. Influenza immunization or infection may cause subacute thyroiditis. We present the first reported case of a fever of unknown origin due to seasonal influenza A in a 67-year-old woman.
    No preview · Article · Jul 2012 · Heart & lung: the journal of critical care
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