Majed Zeinab K, Janji Miril, Basma Hadil, Atallah Paola
Department of Endocrinology, Diabetes and Metabolism, Faculty of Medicine, Lebanese University, Beirut, LBN.
Department of Endocrinology and Metabolism, Saint George Hospital University Medical Center, Beirut, LBN.
Cureus. 2025 Jun 11;17(6):e85747. doi: 10.7759/cureus.85747. eCollection 2025 Jun.
Subacute thyroiditis (SAT) is a transient inflammatory thyroid disorder, typically following an upper respiratory tract viral infection, and can rarely present as fever of unknown origin (FUO). Considering endocrine diseases in the differential diagnosis of fever is essential to prevent delayed diagnosis and unnecessary investigations. We report a case of a 65-year-old male who presented with a prolonged fever of two to three weeks, unresponsive to antibiotics, starting with mild upper respiratory symptoms. Extensive infectious and other workups were negative. Thyroid function tests revealed suppressed thyroid-stimulating hormone (TSH) and elevated free thyroxine (T4) and triiodothyronine (T3) levels. Thyroid ultrasound findings were consistent with thyroiditis. The patient was diagnosed with SAT and treated with corticosteroids, leading to rapid symptom resolution. SAT can be overlooked in the evaluation of FUO, particularly in the absence of classic symptoms. Thyroid function testing can be considered in the routine workup of FUO. Treatment should be based on symptoms, with an appropriate corticosteroid regimen if needed, and proper follow-up is essential to monitor thyroid recovery and potential progression.
亚急性甲状腺炎（SAT）是一种短暂性炎症性甲状腺疾病，通常继发于上呼吸道病毒感染，很少表现为不明原因发热（FUO）。在发热的鉴别诊断中考虑内分泌疾病对于防止漏诊和不必要的检查至关重要。我们报告一例65岁男性患者，其出现持续两到三周的发热，对抗生素无反应，起初有轻微上呼吸道症状。广泛的感染及其他检查均为阴性。甲状腺功能检查显示促甲状腺激素（TSH）降低，游离甲状腺素（T4）和三碘甲状腺原氨酸（T3）水平升高。甲状腺超声检查结果与甲状腺炎相符。该患者被诊断为亚急性甲状腺炎并接受皮质类固醇治疗，症状迅速缓解。在不明原因发热的评估中，亚急性甲状腺炎可能被忽视，尤其是在没有典型症状的情况下。在不明原因发热的常规检查中可考虑进行甲状腺功能检测。治疗应基于症状，必要时采用适当的皮质类固醇治疗方案，并且进行适当的随访对于监测甲状腺恢复情况和潜在进展至关重要。
