Thyrotoxicosis misdiagnosed as long COVID by telemedicine – a cautionary tale
Introduction: Individuals who have had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop post-coronavirus disease conditions, also known as long COVID. The symptoms of long COVID are nonspecific, and there are similarities between the symptoms of long COVID and those...
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| Format: | Article |
| Language: | English |
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SMC MEDIA SRL
2024-01-01
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| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/4206 |
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| author | Toshitaka Sawamura Shigehiro Karashima Mitsuhiro Kometani Ai Ohmori Takashi Yoneda |
| author_facet | Toshitaka Sawamura Shigehiro Karashima Mitsuhiro Kometani Ai Ohmori Takashi Yoneda |
| author_sort | Toshitaka Sawamura |
| collection | DOAJ |
| description | Introduction: Individuals who have had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop post-coronavirus disease conditions, also known as long COVID. The symptoms of long COVID are nonspecific, and there are similarities between the symptoms of long COVID and those of Graves’ disease (GD). Therefore, it is important to rule out GD in patients suspected of having long COVID. Telemedicine is widely used to avoid the risk of SARS-CoV-2 infection. However, owing to the lack of in-person examinations, diagnostic errors can occur.
Case description: A 27-year-old Japanese woman presented complaining of persistent fatigue, dyspnea, and low-grade fever, and after in-person examination was finally diagnosed with GD. She had been diagnosed with SARS-CoV-2 infection four months earlier and her symptoms had resolved within 5 days but then recurred. Subsequently, she had 3 telemedicine visits and had been diagnosed with long COVID.
Discussion: With telemedicine there may be delayed diagnosis of GD in patients with a recent history of SARS-CoV-2 infection. Some symptoms and abnormalities cannot be confirmed in telemedicine visits performed using a simple mobile phone. Therefore it is important to know which findings obtained in telemedicine visits with a simple mobile phone are suggestive of GD. Low-grade fever and tachycardia are often observed in patients with GD, but rarely occur in patients with long COVID.
Conclusion: Tachycardia and persistent low-grade fever after SARS-CoV-2 infection, which can be confirmed by telemedicine, can be clues for the diagnosis of GD. Therefore, in-person examination should be added if these symptoms are confirmed by telemedicine. |
| first_indexed | 2024-03-08T04:44:40Z |
| format | Article |
| id | doaj.art-4c0c1b088bb9437bbdf903552e3eb1c8 |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-03-08T04:44:40Z |
| publishDate | 2024-01-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-4c0c1b088bb9437bbdf903552e3eb1c82024-02-08T10:55:15ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942024-01-0110.12890/2024_0042063741Thyrotoxicosis misdiagnosed as long COVID by telemedicine – a cautionary taleToshitaka Sawamura0Shigehiro Karashima1Mitsuhiro Kometani2Ai Ohmori3Takashi Yoneda4Department of Internal Medicine, Asanogawa General Hospital, Kanazawa, Japan; Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, Kanazawa, Japan; Department of Health Promotion and Medicine of the Future, Kanazawa University, Kanazawa, JapanDepartment of Health Promotion and Medicine of the Future, Kanazawa University, Kanazawa, JapanDepartment of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, Kanazawa, Japan; Department of Health Promotion and Medicine of the Future, Kanazawa University, Kanazawa, JapanDepartment of Internal Medicine, Asanogawa General Hospital, Kanazawa, Japan; Department of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, Kanazawa, JapanDepartment of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, Kanazawa, Japan; Department of Health Promotion and Medicine of the Future, Kanazawa University, Kanazawa, JapanIntroduction: Individuals who have had severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may develop post-coronavirus disease conditions, also known as long COVID. The symptoms of long COVID are nonspecific, and there are similarities between the symptoms of long COVID and those of Graves’ disease (GD). Therefore, it is important to rule out GD in patients suspected of having long COVID. Telemedicine is widely used to avoid the risk of SARS-CoV-2 infection. However, owing to the lack of in-person examinations, diagnostic errors can occur. Case description: A 27-year-old Japanese woman presented complaining of persistent fatigue, dyspnea, and low-grade fever, and after in-person examination was finally diagnosed with GD. She had been diagnosed with SARS-CoV-2 infection four months earlier and her symptoms had resolved within 5 days but then recurred. Subsequently, she had 3 telemedicine visits and had been diagnosed with long COVID. Discussion: With telemedicine there may be delayed diagnosis of GD in patients with a recent history of SARS-CoV-2 infection. Some symptoms and abnormalities cannot be confirmed in telemedicine visits performed using a simple mobile phone. Therefore it is important to know which findings obtained in telemedicine visits with a simple mobile phone are suggestive of GD. Low-grade fever and tachycardia are often observed in patients with GD, but rarely occur in patients with long COVID. Conclusion: Tachycardia and persistent low-grade fever after SARS-CoV-2 infection, which can be confirmed by telemedicine, can be clues for the diagnosis of GD. Therefore, in-person examination should be added if these symptoms are confirmed by telemedicine.https://www.ejcrim.com/index.php/EJCRIM/article/view/4206long covidgraves’ diseasetelemedicinedelayed diagnosis |
| spellingShingle | Toshitaka Sawamura Shigehiro Karashima Mitsuhiro Kometani Ai Ohmori Takashi Yoneda Thyrotoxicosis misdiagnosed as long COVID by telemedicine – a cautionary tale European Journal of Case Reports in Internal Medicine long covid graves’ disease telemedicine delayed diagnosis |
| title | Thyrotoxicosis misdiagnosed as long COVID by telemedicine – a cautionary tale |
| title_full | Thyrotoxicosis misdiagnosed as long COVID by telemedicine – a cautionary tale |
| title_fullStr | Thyrotoxicosis misdiagnosed as long COVID by telemedicine – a cautionary tale |
| title_full_unstemmed | Thyrotoxicosis misdiagnosed as long COVID by telemedicine – a cautionary tale |
| title_short | Thyrotoxicosis misdiagnosed as long COVID by telemedicine – a cautionary tale |
| title_sort | thyrotoxicosis misdiagnosed as long covid by telemedicine a cautionary tale |
| topic | long covid graves’ disease telemedicine delayed diagnosis |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/4206 |
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