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. 2022 Jul 20;9(7):003470.
doi: 10.12890/2022_003470. eCollection 2022.

Graves' Disease Caused by SARS-CoV-2 Infection

Bruno Sousa  1 , Catarina Pestana Santos  1 , Ana Gonçalves Ferreira  2 , Tiago Judas  1
Affiliations

Graves' Disease Caused by SARS-CoV-2 Infection

Bruno Sousa et al. Eur J Case Rep Intern Med. .

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.

Learning points: Graves' disease may be induced after SARS-CoV-2 infection by a possible autoimmune pathway.Graves' disease induced by SARS-CoV-2 infection responds well to antithyroid medication.

Keywords: Graves’ disease; SARS-CoV-2; hyperthyroidism.

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Conflict of interest statement

Conflicts of Interests: The authors declare there are no competing interests.

Figures

Figure 1
Figure 1
Thyroid scintigraphy excluded the nodule and confirmed a Graves’ disease pattern
See this image and copyright information in PMC

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