Indian Journal of Endocrinology and Metabolism

BRIEF COMMUNICATION
Year
: 2012  |  Volume : 16  |  Issue : 8  |  Page : 340--341

Subacute thyroiditis: An uncommon cause of fever of unknown origin


Sambit Das 
 Department of Endocrinology, Apollo Hospitals, Bhubaneswar, India

Correspondence Address:
Sambit Das
Department of Endocrinology, Apollo Hospitals, Bhubaneswar, Orissa
India

Abstract

Subacute thyroiditis (SAT) is a self-limited, possibly viral, inflammatory thyroid disorder usually associated with thyroid pain and systemic disorder. SAT is not uncommon and can present with pyrexia of unknown origin. High index of suspicion is required and cases are managed symptomatically.



How to cite this article:
Das S. Subacute thyroiditis: An uncommon cause of fever of unknown origin.Indian J Endocr Metab 2012;16:340-341


How to cite this URL:
Das S. Subacute thyroiditis: An uncommon cause of fever of unknown origin. Indian J Endocr Metab [serial online] 2012 [cited 2021 Sep 19 ];16:340-341
Available from: https://www.ijem.in/text.asp?2012/16/8/340/104083


Full Text

 Introduction



Subacute thyroiditis (SAT) is a self-limited, possibly viral, inflammatory thyroid disorder usually associated with thyroid pain and systemic symptoms. There are few case reports of presentation of SAT as fever of unknown origin (FUO). [1],[2],[3]

 Materials and Methods



This is a retrospective analysis of 12 patients of SAT, presenting in a tertiary care hospital of eastern India from April 2010 to July 2012. We describe the clinical presentation, investigation, management, and outcome of the patients with SAT.

 Results



Twelve patients (seven males and five females) were diagnosed with SAT with mean age of presentation 51 years (range 45-60 years). Fever of more than 3 weeks satisfying the definition of FUO was found in 10 (83.3%) patients. Neck pain and tenderness were found in 11 out of 12 patients (91.6%). One had presented with acute fever with erythema over the neck mimicking acute infective thyroiditis. Five patients were newly diagnosed with diabetes mellitus, and one had impaired fasting, and one impaired glucose tolerance. Markers of inflammation like raised erythrocyte sedimentation rate (ESR) and CRP, ultrasonography (USG) features suggestive of thyroiditis and no uptake in thyroid scan were found in all cases. fine needle aspiration cytology (FNAC) in six patients showed multinucleated giant cells. Analgesics and beta blockers were given to all patients, and 8 (66.6%) of them required steroids to alleviate the severe symptoms. Recurrence of the illness was found in only 2 (16.6%) individuals, after stopping the steroid. Seven patients (58.3%) developed subclinical or overt hypothyroidism at 3 months of follow-up.

 Conclusion



SAT is not an uncommon entity and may present with FUO. High index of suspicion and symptomatic management with analgesics, beta blockers and sometimes with oral steroid lead to remission with low recurrence rate.

References

1Karachalios GN, Amantos K, Kanakis KV, Deliousis A, Karachaliou IG, Zacharof AK. Subacute thyroiditis presenting as fever of unknown origin. Int J Clin Pract 2010;64:97-8.
2Alexander V, Kurien TT, Chattopadhyay A. An uncommon endocrine cause of pyrexia of unknown origin. J Assoc Physicians India 2009;57:527-8.
3Cunha BA, Berbari N. Subacute thyroiditis (de Quervain's) due to influenza A: Presenting as fever of unknown origin (FUO). Heart Lung 2012. [In press].