{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T17:27:22Z","timestamp":1755797242553,"version":"3.44.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>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 \u03b2-cell function remained absent, necessitating lifelong insulin therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1644656","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T16:24:07Z","timestamp":1755534247000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: SARS-CoV-2-associated immune dysfunction manifesting as concurrent fulminant type 1 diabetes mellitus and subacute thyroiditis"],"prefix":"10.3389","volume":"12","author":[{"given":"Wei","family":"Fang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huanping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lian","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongxia","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1056\/NEJM200002033420501","article-title":"A novel subtype of type 1 diabetes mellitus characterized by a rapid onset and an absence of diabetes-related antibodies. 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