• Eliel Nham, Eyun Song, Hakjun Hyun, Hye Seong, Jin Gu Yoon, Ji Yun Noh, Joon Young Song, Hee Jin Cheong, and Woo Joo Kim.
• Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
• J. Korean Med. Sci. 2023 May 8; 38 (18): e134e134.

AbstractThere are many reports of subacute thyroiditis (SAT) that occurred after the coronavirus disease 2019 (COVID-19), but no such case has been reported in Korea. Moreover, the simultaneous occurrence of SAT and Graves' disease (GD) is rare. Here, we describe a patient who developed SAT and GD after the second episode of COVID-19. A 27-year-old woman with no known history of thyroid disease presented with fever, upper respiratory tract symptoms, and painful neck swelling. Thyroid function tests revealed thyrotoxicosis, and thyroid ultrasound showed heterogeneous echogenicity of enlarged thyroid glands. Her initial clinical presentation was consistent with SAT after viral infection, with typical neck tenderness and spontaneous improvement of thyrotoxicosis without antithyroid drug use. However, this case had some atypical features, such as an elevated thyroid-stimulating immunoglobulin level, relapse of thyrotoxicosis in short-term follow-up, and increased Tc-99m pertechnetate uptake, suggesting the coexistence of GD. About two months after methimazole (15 mg/day) was prescribed, she was lost to follow up again. We report the first case of unusual co-occurrence of SAT and GD following COVID-19.© 2023 The Korean Academy of Medical Sciences.

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