Čes-slov Pediat 2024, 79(89):S30-S34 | DOI: 10.55095/CSPediatrie2024/040

An unusual cause of hyperthyroidism in a teenage girlCase Histories

Ondřej Veselý^1,2

¹ Svitavská nemocnice, Nemocnice Pardubického kraje a. s., Svitavy

² Dětská klinika, Fakultní nemocnice Olomouc

Subacute thyroiditis is an uncommon cause of hyperthyroidism, particularly in children and adolescents. The etiopathogenesis remains unclear; however, current evidence suggests that a viral trigger leads to destructive thyroiditis in patients with a specific genetic predisposition. We present the case of a 14-year-old girl who experienced neck pain for 10 days, accompanied by fever, nervousness, sweating, and tachycardia. Laboratory tests revealed elevated levels of free thyroxine and free triiodothyronine, suppressed thyroid stimulating hormone (TSH), leukocytosis, an increased erythrocyte sedimentation rate, and high C-reactive protein. Thyroid antibodies, including TSH receptor antibody, were negative. Ultrasonography showed an enlarged thyroid gland with hypoechoic areas and low vascularity. The patient was treated with prednisone in a tapering dose, leading to resolution of both local and systemic symptoms within two weeks. Follow-up ultrasonography showed normalization of the thyroid gland within three months. The patient developed transient hypothyroidism following the hyperthyroid phase, requiring short-term levothyroxine substitution, which was discontinued six months after diagnosis. Currently, the patient is euthyroid and remains under outpatient follow-up.

Keywords: subacute thyroiditis, hyperthyroidism, corticosteroids

Received: May 17, 2024; Revised: June 14, 2024; Accepted: June 17, 2024; Published: December 1, 2024  Show citation