Endocrine Abstracts

Background: Subacute thyroiditis is an inflammatory condition of the thyroid with characteristic presentations and clinical course. Patients with the classic, painful (DeQuervain′s; Granulomatous) thyroiditis, (PFSAT) typically present with painful swelling of the thyroid. At times, the pain begins and may be confined to the one lobe, but usually spreads rapidly to involve the rest of the gland. Pain may radiate to the jaw or the ears. Malaise, fatigue, myalgia and arthralgia are common. A mild to moderate fever is expected, and at times a high fever of 104°F (40.0°C) may occur. It is suggested that the etiology of the disease is mainly viral, in addition, subacute thyroiditis often develops after infection of the upper respiratory tract, influenza, measles. COVID 19 is a potentially severe, primarily respiratory illness caused by a coronavirus and characterized by fever, coughing, and shortness of breath. In some people, the disease also damages major organs.

Aim: This study attempts to review the correlation of PFSAT and COVID 19

Method: Within months after the onset of the Covid pandemic, the number of patients referring to the National Center for Diabetes Research and diagnosed with of PFSAT has increased dramatically. Anamnesis showed that the vast majority had suffered Covid-19. Observations were made on 12 patients (8 females/4 males, mean age 22–51 years,) who had a history of Csovid-19 within past 2-3 months.

Discussion: The following studies were performed: test for Covid 19 antibodies and thyroid function tests (TSH and elevation of total T4 and T3 levels consistent with the thyrotoxic state). T3 (ng/dl) to T4 (mg/dl) ratio was less than 20. ESR (>50), CRP and thyroglobulin were all elevated; TPO-ab, Tg-ab and TSHR-ab were negative; RAIU/Scan-thyroid gland was ”low or not” visible; ultrasound echogeneity was hypoechoic and vascularity was decreased. Classical treatment of subacute thyroiditis was started initially with non-steroidal anti-inflammatory agents, but the majority of patients (91%) required treatment with prednisone (20-40 mg daily). Beta blocking agents were prescribed in the majority of patients (76%). Most patients recovered in 6-8 weeks.

Conclsion: Data of our small research have shown that Covid 19 can cause sub-acute thyroiditis, though its course does not differ from the classical sub-acute thyroiditis. Data of new large-scale studiesare needed. We plan to continue our observations and increase the number of patients involved.