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Thursday, 26 July 2018

Atrial Fibrillation in a Patient with Subacute Thyroiditis


                                           http://austinpublishinggroup.com/thyroid-research/




Thyrotoxicosiscaused by subacute thyroiditis is self-limited and results from the subacute release of preformed thyroid hormone. Our data showed that the hyperthyroid state may last for 1 or 2 months as the stored thyroid hormone is depleted. It may be followed by a hypothyroid phase in approximately 60% of the cases, but 91% of them return to the euthyroid state and the remaining 9% remained hypothyroid, as presented in Figure.

Atrial fibrillation occurs in up to 15% of patients with hyperthyroidism compared to 4% of people in the general population and more common in men. But the case report of subacute thyroiditis with atrial fibrillation is rare. We report the case of a 54-year-old man with subacute thyroiditis who had unexpected atrial fibrillation.

A 54-year-old man presented to our observation in November 2017 with 10 days of neck pain, high fever, chills, fatigue, sweating, dysphagia, odynophagia, palpitation, and an 8kg weight loss. A recent history of upper respiratory tract infection was not evident. Bilateral thyroid pain and tenderness were noted. Past medical history was not significant. Family history was pertinent for his niece with hyperthyroidism. On physical examination, the patient had a temperature of 39.9oC, blood pressure of 110/70 mmHg, and weight of 55kg. There was no proptosis, lid lag, conjunctiva; redness, periorbital edema, or erythema. His thyroid gland was enlarged to 48g (normal range 15-35g) estimated by ultrasonography without palpable nodules or lymphadenopathy. Both sides of the anterior thyroid gland were tender to palpation.

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