Graves’ Disease Caused by SARS-CoV-2 Infection

Bruno Sousa; Catarina  Pestana Santos; Ana Gonçalves Ferreira; Tiago  Judas

doi:10.12890/2022_003470

Graves’ Disease Caused by SARS-CoV-2 Infection

Bruno Sousa Internal Medicine Department , Hospital Garcia de Orta, Almada, Lisbon, Portugal
Catarina Pestana Santos Internal Medicine Department , Hospital Garcia de Orta, Almada, Lisbon, Portugal
Ana Gonçalves Ferreira Endocrinology Department, Hospital Garcia de Orta, Almada, Lisbon, Portugal
Tiago Judas Internal Medicine Department , Hospital Garcia de Orta, Almada, Lisbon, Portugal

DOI: https://doi.org/10.12890/2022_003470

Keywords

Graves’ disease, SARS-CoV-2, hyperthyroidism

Abstract

Graves’ disease is an autoimmune disorder that results in hyperthyroidism, caused by autoantibodies to the thyrotropin receptor (TRAbs) stimulating thyroid hormone synthesis, giving rise to a variety of systemic manifestations such as goitre, dermatopathy and orbitopathy.

The authors present the case of a 28-year-old man admitted to hospital for a 3-week history of fatigue, shortness of breath, palpitations and diffuse goitre, after recent mild SARS-CoV-2 infection. Laboratory investigation revealed hyperthyroidism with TRAbs elevation. Thyroid ultrasound confirmed a diffusely heterogeneous and irregular thyroid gland and a nodular image below the sternal notch. Thyroid scintigraphy excluded the nodule and confirmed a Graves’ disease pattern. Following the initiation of methimazole, the patient had complete resolution of symptoms and normalization of thyroid values.

The results suggest a possible association between Graves’ disease and SARS-CoV-2 infection acting as a trigger. Graves’ disease is an important differential diagnosis to keep in mind when patients present with hyperthyroidism after COVID-19 disease.

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