Profile of thyrotoxic patients presenting as pyrexia of unkown origin: An observational case study from a tertiary care hospital

  • Dr. Nazir Ahmad Pala Lecturer, Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Dr. Mohd Ashraf Assistant Professor, Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
  • Dr. Badrinath Bhoughal Associate Professor, Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
Keywords: Thyrotoxic PUO, Acetylsalicylic, Corticosteroids, Post-thyroiditis hypothyroidism

Abstract

Objective: To study the profile of thyrotoxic patients evaluated for pyrexia of unknown origin (PUO).

Methods: 25 patients, who were evaluated for pyrexia of unknown origin and found to have thyrotoxicosis as the cause for fever, were managed as per the recommended protocol and followed for 12 months.

Results: All the patients were presumed to have infectious fever and had received antibiotics prior to diagnosis. Out of 25 patients, 20 (80%) had subacute thyroiditis (SAT) and 5 (20%) had hyperthyroidism (4 had Graves disease and 1 toxic adenoma). Patients with hyperthyroidism received thionamides and β- blockers. 50% patients with subacute thyroiditis received analgesics, 25% received steroids only and 25% received a combination of analgesics and steroids. Early-onset transient hypothyroidism occurred in 40% patients with SAT, permanent hypothyroidism was less common and only 15% of patients were receiving levothyroxine therapy after one year of follow-up.

Conclusion: Thyrotoxicosis should always be included in the differential diagnosis while evaluation of patients with PUO. Most of the patients with thyrotoxicosis are wrongly misinterpreted as infectious PUO and given unnecessary antibiotics. Early-onset transient hypothyroidism is common in SAT compared to permanent hypothyroidism. Although, symptomatic relief is achieved with analgesics and steroids but does not prevent the development of hypothyroidism.

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Profile of thyrotoxic patients presenting as pyrexia of unkown origin: An observational case study from a tertiary care hospital
CITATION
DOI: 10.17511/ijmrr.2019.i01.06
Published: 2019-02-28
How to Cite
1.
Ahmad Pala N, Mohd A, Bhoughal B. Profile of thyrotoxic patients presenting as pyrexia of unkown origin: An observational case study from a tertiary care hospital. Int J Med Res Rev [Internet]. 2019Feb.28 [cited 2024Mar.29];7(1):30-5. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/1032
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Original Article