Graves' disease presenting as pyrexia of unknown origin

• Published in: Postgraduate Medical Journal Vol. 64; no. 749; pp. 209 - 212
• Main Authors: Shaked, Y., Samra, Y., Zwas, S. T.
• Format: Journal Article Book Review
• Language: English
• Published: England The Fellowship of Postgraduate Medicine 01.03.1988; Oxford University Press; BMJ Group
• Subjects: Female; Fever of Unknown Origin - etiology; Graves Disease - complications; Graves Disease - drug therapy; Humans; Methimazole - therapeutic use; Middle Aged
• ISSN: 0032-5473; 1469-0756
• DOI: 10.1136/pgmj.64.749.209

Fever is a common clinical manifestation of inflammatory processes of the thyroid and thyroid crisis. On the other hand, fever alone as a presenting symptom of thyrotoxicosis, without other manifestations, is extremely rare. A female patient is described in whom fever persisted for two months prior to hospitalization, but without clinical symptoms or signs to lead to suspicion of thyroid disease. After exhaustive investigation it was found that the patient was suffering from hyperthyroidism. Fever disappeared gradually on antithyroid therapy, recurred when the drugs were withdrawn for a rechallenge trial, and cleared up again after renewal. Four other cases of persistent fever as a presenting symptom of hyperthyroidism were found on a review of previous publications. Thyrotoxicosis should, therefore, be included in the differential diagnosis of pyrexia of unknown origin.