ArticleFrontiers in medicine2025
Case Report: SARS-CoV-2-associated immune dysfunction manifesting as concurrent fulminant type 1 diabetes mellitus and subacute thyroiditis.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: The association between SARS-CoV-2 infection and endocrine emergencies (such as fulminant type 1 diabetes mellitus and subacute thyroiditis) has received increasing attention. However, concurrent manifestations of these two conditions within a short period of time after infection are exceedingly rare, and the underlying mechanisms and clinical management strategies remain unclear. Case presentation: A 45-year-old Chinese man developed sudden polydipsia, polyuria, and cervical pain on day 7, within 2 weeks of SARS-CoV-2 infection. The diagnosis of fulminant type 1 diabetes mellitus complicated by subacute thyroiditis (SAT) was confirmed through laboratory investigations (arterial blood gas analysis, C-peptide release test, and thyroid ultrasound) and imaging. Treatments included fluid resuscitation, continuous intravenous insulin infusion (0.1 U/kg/h), and prednisone (30 mg/day). Acidosis was corrected within 48 h, and SAT symptoms resolved by day 8. At the 6-month follow-up, SAT had completely resolved, but pancreatic β-cell function remained absent, necessitating lifelong insulin therapy. Conclusion: This case suggests that SARS-CoV-2 may induce dual-gland damage through immune injury mediated by angiotensin-converting enzyme 2 receptor and cytokine storms. Clinicians should be vigilant for acute hyperglycemia and neck pain following SARS-CoV-2 infection. Serial monitoring of blood glucose and thyroid-related parameters is essential as early intervention may improve prognosis.
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