Abstract
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 Fever disappeared gradually on antithyroid therapy, recurred when the drugs were withdrawn for a rechallenge trial, and cleared up again after renewal.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.
Full text
PDF



Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aduan R. P., Fauci A. S., Dale D. C., Herzberg J. H., Wolff S. M. Factitious fever and self-induced infection: a report of 32 cases and review of the literature. Ann Intern Med. 1979 Feb;90(2):230–242. doi: 10.7326/0003-4819-90-2-230. [DOI] [PubMed] [Google Scholar]
- Brooks M. H., Waldstein S. S., Bronsky D., Sterling K. Serum triiodothyronine concentration in thyroid storm. J Clin Endocrinol Metab. 1975 Feb;40(2):339–341. doi: 10.1210/jcem-40-2-339. [DOI] [PubMed] [Google Scholar]
- Dalovisio J. R., Blonde L., Cortez L. M., Pankey G. A. Subacute thyroiditis with increased serum alkaline phosphatase. Ann Intern Med. 1978 Apr;88(4):505–507. doi: 10.7326/0003-4819-88-4-505. [DOI] [PubMed] [Google Scholar]
- Davis P. J., Davis F. B. Hyperthyroidism in patients over the age of 60 years. Clinical features in 85 patients. Medicine (Baltimore) 1974 May;53(3):161–181. doi: 10.1097/00005792-197405000-00001. [DOI] [PubMed] [Google Scholar]
- Edelman I. S. Thyroid thermogenesis. N Engl J Med. 1974 Jun 6;290(23):1303–1308. doi: 10.1056/NEJM197406062902308. [DOI] [PubMed] [Google Scholar]
- Gleckman R., Crowley M., Esposito A. Fever of unknown origin: a view from the community hospital. Am J Med Sci. 1977 Jul-Aug;274(1):21–25. doi: 10.1097/00000441-197707000-00003. [DOI] [PubMed] [Google Scholar]
- Izmail-Beigi F., Edelman I. S. Mechanism of thyroid calorigenesis: role of active sodium transport. Proc Natl Acad Sci U S A. 1970 Oct;67(2):1071–1078. doi: 10.1073/pnas.67.2.1071. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Larson E. B., Featherstone H. J., Petersdorf R. G. Fever of undetermined origin: diagnosis and follow-up of 105 cases, 1970-1980. Medicine (Baltimore) 1982 Sep;61(5):269–292. [PubMed] [Google Scholar]
- Levine S. N. Current concepts of thyroiditis. Arch Intern Med. 1983 Oct;143(10):1952–1956. [PubMed] [Google Scholar]
- Molavi A., Weinstein L. Persistent perplexing pyrexia: some comments on etiology and diagnosis. Med Clin North Am. 1970 Mar;54(2):379–396. [PubMed] [Google Scholar]
- Musher D. M., Fainstein V., Young E. J., Pruett T. L. Fever patterns. Their lack of clinical significance. Arch Intern Med. 1979 Nov;139(11):1225–1228. doi: 10.1001/archinte.139.11.1225. [DOI] [PubMed] [Google Scholar]
- PETERSDORF R. G., BEESON P. B. Fever of unexplained origin: report on 100 cases. Medicine (Baltimore) 1961 Feb;40:1–30. doi: 10.1097/00005792-196102000-00001. [DOI] [PubMed] [Google Scholar]
- PETTERSON T. Fever of obscure origin. A follow-up investigation of 88 cases. Acta Med Scand. 1962 May;171:575–583. [PubMed] [Google Scholar]
- SHEON R. P., VAN OMMEN R. A. Fever of obscure origin. Diagnosis and treatment based on a series of sixty cases. Am J Med. 1963 Apr;34:486–499. doi: 10.1016/0002-9343(63)90072-x. [DOI] [PubMed] [Google Scholar]
- Simon H. B., Daniels G. H. Hormonal hyperthermia: endocrinologic causes of fever. Am J Med. 1979 Feb;66(2):257–263. doi: 10.1016/0002-9343(79)90542-4. [DOI] [PubMed] [Google Scholar]

