Bhatt Varsha R, Khaladkar Sanjay M, Edara Manaswini
Department of Medicine, Rheumatology Clinic, Dr. D.Y Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India.
Department of Radiodiagnosis, Dr. D.Y Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India.
Mediterr J Rheumatol. 2023 Mar 31;34(1):101-104. doi: 10.31138/mjr.34.1.101. eCollection 2023 Mar.
Systemic lupus erythematosus may present with fever, and it is a challenge to attribute fever to a particular cause. Very rarely it can be due to hyperthyroidism. Thyroid storm is a medical emergency causing unrelenting pyrexia. Here we report a case of a young female who first presented as fever of unknown origin (FUO), was subsequently diagnosed as neuropsychiatric lupus, and in whom the cause of unrelenting high fever, which did not respond to adequate immunosuppression to quell disease activity, was documented to be thyroid storm after excluding all other causes such as infection and malignancy. To our knowledge, this is the first case of this kind reported in literature, although cases of thyrotoxicosis preceding or following the diagnosis of lupus is known. Her fever resolved after starting antithyroid drugs and beta blockers.
系统性红斑狼疮可能会出现发热症状，而将发热归因于某一特定原因颇具挑战性。极罕见情况下，发热可能是由甲状腺功能亢进引起。甲状腺危象是一种导致持续发热的医疗急症。在此，我们报告一例年轻女性病例，该患者最初表现为不明原因发热（FUO），随后被诊断为神经精神性狼疮，在排除感染和恶性肿瘤等所有其他原因后，证实其持续高热的原因是甲状腺危象，尽管给予了足够的免疫抑制治疗以平息疾病活动，但高热仍未消退。据我们所知，这是文献中报道的首例此类病例，不过狼疮诊断之前或之后出现甲状腺毒症的病例是已知的。在开始使用抗甲状腺药物和β受体阻滞剂后，她的发热症状得以缓解。
