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Euthyroid atypical subacute thyroiditis simulating systemic or malignant disease.

Z Rotenberg, I Weinberger, J Fuchs

    Archives of Internal Medicine
    |January 1, 1986
    PubMed
    Summary
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    Atypical subacute thyroiditis (SAT) can mimic serious illnesses with prolonged fever and weight loss. Early recognition of this SAT variant prevents unnecessary diagnostic procedures for systemic or malignant diseases.

    Area of Science:

    • Endocrinology
    • Internal Medicine
    • Pathology

    Background:

    • Subacute thyroiditis (SAT) is an inflammatory thyroid condition.
    • Atypical presentations of SAT can mimic other systemic or malignant diseases.

    Purpose of the Study:

    • To describe an unusual form of atypical subacute thyroiditis (SAT).
    • To highlight the diagnostic challenges and key features of this SAT variant.

    Main Methods:

    • Case series of 13 patients with atypical SAT.
    • Clinical evaluation including symptoms, physical examination, and laboratory tests.
    • Histopathological examination via needle biopsy in 10 patients.

    Main Results:

    • Patients presented with prolonged fever and weight loss, simulating systemic or malignant disease.

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  • Thyroid tenderness and thyrotoxicosis symptoms were absent.
  • Normal serum free thyroxine levels were observed in 11 patients.
  • Histologic findings in needle biopsies were consistent with typical SAT.
  • Diagnosis in three patients was based on high erythrocyte sedimentation rate, low radioactive iodine uptake, and response to aspirin or prednisone.

    • Conclusions:

    • Atypical SAT can present insidiously, mimicking more severe conditions.
    • Key diagnostic indicators include elevated ESR, low radioactive iodine uptake, and therapeutic response to salicylates or steroids.
    • Early identification of this atypical SAT presentation can avert extensive investigations for systemic or malignant diseases.