Subacute Thyroiditis After Sars-COV-2 Infection
Subacute Thyroiditis After Sars-COV-2 Infection
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DOI：
10.1210/clinem/dgaa276
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发表时间：
2020-07-01
影响因子：
5.8
通讯作者：
Latrofa, Francesco
中科院分区：
文献类型：
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作者：
Brancatella, Alessandro;Ricci, Debora;Latrofa, Francesco
背景：亚急性甲状腺炎（SAT）是一种病毒或病毒后起源的甲状腺疾病。始于中国武汉的严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 已在全球范围内迅速传播，意大利受到此次疫情的严重影响。 目的：这项工作的目的是报告第一例与 SARS-CoV-2 感染相关的 SAT 病例。 方法：我们描述了一名 18 岁女性的临床、实验室和影像学特征，该女性因发热、颈部放射至下巴的疼痛以及在感染后 15 天出现心悸而引起我们的注意。 SARS-CoV-2 阳性口咽拭子。 2019 冠状病毒病 (COVID-19) 症状较轻，患者在几天内已完全康复。结果：体检时，患者心率略有加快，触诊时甲状腺疼痛且肿大。实验室检查中游离甲状腺素和游离三碘甲状腺原氨酸较高，促甲状腺素检测不到，炎症标志物和白细胞计数升高。颈部超声检测到双侧和弥漫性低回声区域。一个月前，甲状腺功能和影像学均正常。我们诊断出 SAT，患者开始服用泼尼松。颈部疼痛和发烧在 2 天内恢复，其余症状在 1 周内恢复。甲状腺功能和炎症标志物在 40 天内恢复正常。结论：我们报告了第一例 SARS-CoV-2 感染后的 SAT 病例。我们提醒临床医生注意与 COVID-19 相关的其他和未报告的临床表现。
Context: Subacute thyroiditis (SAT) is a thyroid disease of viral or postviral origin. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has spread rapidly worldwide and Italy has been severely affected by this outbreak.Objectives: The objective of this work is to report the first case of SAT related to SARS-CoV-2 infection.Methods: We describe the clinical, laboratory, and imaging features of an 18-year-old woman who came to our attention for fever, neck pain radiated to the jaw, and palpitations occurring 15 days after a SARS-CoV-2-positive oropharyngeal swab. Coronavirus disease 2019 (COVID-19) had been mild and the patient had completely recovered in a few days.Results: At physical examination the patient presented with a slightly increased heart rate and a painful and enlarged thyroid on palpation. At laboratory exams free thyroxine and free triiodothyronine were high, thyrotropin undetectable, and inflammatory markers and white blood cell count elevated. Bilateral and diffuse hypoechoic areas were detected at neck ultrasound. One month earlier, thyroid function and imaging both were normal. We diagnosed SAT and the patient started prednisone. Neck pain and fever recovered within 2 days and the remaining symptoms within 1 week. Thyroid function and inflammatory markers normalized in 40 days.Conclusions: We report the first case of SAT after a SARS-CoV-2 infection. We alert clinicians to additional and unreported clinical manifestations associated with COVID-19.