Ngwengi Yembu, Nida Martine, Kamga Olive, Fonyam Vincent
Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Littoral, Cameroon.
Department of Internal Medicine, Marie O Polyclinic, Somatel Street, Bali, P.O Box 1568, Douala, Littoral, Cameroon.
J Med Case Rep. 2025 Sep 29;19(1):460. doi: 10.1186/s13256-025-05376-y.
Subacute thyroiditis is a self-limiting condition caused by thyroid inflammation. It usually presents with fever, neck pain and symptoms of thyrotoxicosis. Atypical presentations without neck pain are rare and often lead to misdiagnosis, especially in low-resource settings.
We report a case of atypical subacute thyroiditis in a man of Middle Eastern descent that was initially misdiagnosed as tuberculosis, with lymphoma, painless sporadic thyroiditis, and laryngeal malignancy being differentials. The patient, a 41-year-old male, presented with progressively worsening fevers, night sweats, and weight loss, with thyroid cartilage thickening and tenderness on physical exam. He was diagnosed with subacute thyroiditis through Doppler ultrasound scanning of the thyroid gland, elevated inflammatory markers, and the presence of antibody-negative hyperthyroidism on his biochemical thyroid screen. Symptomatic relief was provided with salicylate and prednisolone. The patient experienced transient asymptomatic hypothyroidism 4 months after disease onset, which was not treated. Euthyroidism was achieved 6 months after symptom onset.
Subacute thyroiditis is a rare disease thought to be postviral in origin. It generally presents with fever, neck pain, and signs of thyrotoxicosis and evolves in three phases-a hyperthyroid, hypothyroid, and euthyroid phase. Atypical subacute thyroiditis without neck pain is even rarer; therefore, clinicians should maintain a high index of suspicion for thyroid disorders whenever symptoms suggestive of thyrotoxicosis are encountered, and should always consider thyroid abnormalities when investigating weight loss or persistent fevers in an African setting.
亚急性甲状腺炎是一种由甲状腺炎症引起的自限性疾病。它通常表现为发热、颈部疼痛和甲状腺毒症症状。无颈部疼痛的非典型表现较为罕见，常导致误诊，尤其是在资源匮乏地区。
我们报告一例中东裔男性的非典型亚急性甲状腺炎病例，该病例最初被误诊为结核病，鉴别诊断包括淋巴瘤、无痛性散发性甲状腺炎和喉恶性肿瘤。患者为一名41岁男性，表现为发热、盗汗和体重减轻逐渐加重，体格检查发现甲状腺软骨增厚和压痛。通过甲状腺多普勒超声扫描、炎症标志物升高以及甲状腺生化筛查中存在抗体阴性的甲状腺功能亢进，诊断为亚急性甲状腺炎。给予水杨酸盐和泼尼松龙以缓解症状。患者在疾病发作4个月后出现短暂无症状性甲状腺功能减退，未进行治疗。症状发作6个月后甲状腺功能恢复正常。
亚急性甲状腺炎是一种罕见疾病，被认为起源于病毒感染后。它通常表现为发热、颈部疼痛和甲状腺毒症体征，并经历三个阶段——甲状腺功能亢进期、甲状腺功能减退期和甲状腺功能正常期。无颈部疼痛的非典型亚急性甲状腺炎更为罕见；因此，临床医生在遇到提示甲状腺毒症的症状时，应保持对甲状腺疾病的高度怀疑指数，并且在非洲地区调查体重减轻或持续发热时应始终考虑甲状腺异常。
