Case report: Neglected subacute thyroiditis: a case following COVID-19 vaccination

Area of Science:

• Endocrinology
• Immunology
• Vaccinology

Background:

• Subacute thyroiditis (SAT) is a common, self-limiting thyroid disorder often following viral infections.
• The COVID-19 pandemic saw widespread SARS-CoV-2 vaccine administration, with rare adverse events documented.
• Awareness of atypical SAT presentations is crucial for timely diagnosis and management.

Observation:

• A case of a previously healthy middle-aged female presenting with fever and sore throat 72 hours post-inactivated SARS-CoV-2 vaccination.
• Initial symptoms were misattributed to a common cold, with NSAID treatment only partially effective.
• Endocrinology consultation revealed abnormal thyroid function, elevated ESR/CRP, and characteristic ultrasonographic findings, despite atypical presentation.

Findings:

• The patient was diagnosed with Subacute Thyroiditis (SAT) potentially linked to COVID-19 vaccination.
• Initial NSAID treatment was insufficient for symptom control, indicating a poor response.
• Initiation of steroid therapy led to rapid resolution of fever and neck pain.

Implications:

• This case underscores the need for increased clinical awareness of vaccine-associated Subacute Thyroiditis (SAT).
• Healthcare professionals should consider SAT in patients with relevant symptoms post-vaccination, even with atypical presentations.
• Prompt diagnosis and appropriate treatment, including corticosteroids, are essential for managing vaccine-induced SAT.