{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:35Z","timestamp":1784557055361,"version":"3.55.0"},"reference-count":6,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,11,24]]},"abstract":"Summary<\/jats:title>\n Enteroviruses, including coxsackieviruses and Echovirus, are well known pathogens responsible for the development of thyroiditis. We describe the case of a 49-year-old woman with no personal or family history of thyroid disease who presented to the emergency room with a two-week history of daily fevers up to 39\u00b0C, a sore throat, occasional palpitations and diaphoresis, decreased appetite and an unintentional 10\u2009kg weight loss over the same time course Physical examination revealed mild tachycardia, an intention tremor and a normal-sized, nontender thyroid gland without palpable nodules. The remainder of the physical examination was unremarkable and without stigmata of Graves\u2019 disease. Her initial blood tests revealed overt thyrotoxicosis, elevated liver enzymes, an elevated C-reactive protein, a negative monospot and a positive CMV IgM antibody. Thyroid sonography revealed areas of hypoechogenicity and relatively low vascularity. Fine-needle biopsy showed a lymphocytic infiltrate. The patient was treated symptomatically with propranolol. On follow-up, the patient became euthyroid, and her liver enzymes normalised. Previous cases of CMV-induced thyroiditis occurred in immunosuppressed patients. This is the first reported case of a CMV-mononucleosis-induced thyroiditis in an immunocompetent adult patient and serves as a reminder that viral illnesses are a common cause of thyroiditis with abnormal liver enzymes.<\/jats:p>\n \n Learning points:<\/jats:title>\n \n \n The differential diagnosis of thyrotoxicosis with abnormal liver enzymes includes severe hyperthyroidism and thyroid storm caused by Graves\u2019 disease as well as the thyrotoxic phase of a thyroiditis, usually caused by a virus such as coxsackievirus or, in this case, cytomegalovirus.<\/jats:p>\n <\/jats:list-item>\n \n Cytomegalovirus appears to be a recently recognized causal agent for thyroiditis, both in immunosuppressed and immunocompetent patients.<\/jats:p>\n <\/jats:list-item>\n \n Careful follow-up of thyroid function tests in patients with thyroiditis allows clinicians to determine if patients\u2019 thyroid hormone secretion normalizes or if they remain hypothyroid.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/edm-17-0142","type":"journal-article","created":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T08:55:53Z","timestamp":1511513753000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":2,"title":["Cytomegalovirus-mononucleosis-induced thyroiditis in an immunocompetent patient"],"prefix":"10.1530","volume":"2017","author":[{"given":"V","family":"Larouche","sequence":"first","affiliation":[{"name":"1Resident Adult Endocrinology and Metabolism Training Program, McGill University, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Tamilia","sequence":"additional","affiliation":[{"name":"2Division of Endocrinology Jewish General Hospital, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"key20171130115336433_bib1","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American Thyroid Association Guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis","volume":"26","author":"Ross","journal-title":"Thyroid"},{"key":"key20171130115336433_bib2","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.jbspin.2015.06.001","article-title":"Cytomegalovirus subacute thyroiditis in a patient treated by infliximab for psoriatic arthritis","volume":"83","author":"Andr\u00e9","year":"2016","journal-title":"Joint Bone Spine"},{"key":"key20171130115336433_bib3","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1515\/JPEM.2008.21.2.191","article-title":"An infant with cytomegalovirus-induced subacute thyroiditis","volume":"21","author":"Al-Maawali","year":"2008","journal-title":"Journal of Pediatric Endocrinology and Metabolism"},{"key":"key20171130115336433_bib4","first-page":"1","article-title":"Viruses and thyroiditis: an update","volume":"12","author":"Desailloud","year":"2009","journal-title":"Journal of Virology"},{"key":"key20171130115336433_bib5","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/S0140-6736(57)91438-1","article-title":"Mumps virus and subacute thyroiditis. Evidence of a causal association","volume":"272","author":"Eylan","year":"1957","journal-title":"Lancet"},{"key":"key20171130115336433_bib6","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1210\/jcem-27-9-1275","article-title":"Circulating viral and thyroid antibodies in subacute thyroiditis","volume":"27","author":"Volpe","year":"1967","journal-title":"Journal of Clinical Endocrinology and Metabolism"}],"container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2017\/1\/EDM17-0142.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2017\/1\/EDM17-0142.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:46:45Z","timestamp":1784555205000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,24]]},"references-count":6,"URL":"https:\/\/doi.org\/10.1530\/edm-17-0142","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,24]]}}}