An unusual clinical presentation of subacute granulomatous thyroiditis

Subacute granulomatous thyroiditis is an inflammatory thyroid condition that is presumed to be caused by a viral infection or postviral inflammatory process. It is characterized by neck pain, usually a tender diffuse goiter, and thyrotoxicosis. A case is presented of subacute granulomatous thyroiditis in an adult woman who had no neck pain but presented with morning stiffness in the small joints of the right hand, intermittent abdominal pain, malaise, fever, and myalgia. After the diagnosis had been established, she was treated with propranolol and acetylsalicylic acid, and has fully recovered. In conclusion, this disease may be difficult to diagnose, especially if there is a combination of fever and increased aminotransferases, which can lead to a wrong diagnostic approach.