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SAT-366 Dengue Fever as a Potential Trigger for Autoimmune Thyroid Disease: Exploring a Possible Link

Year: 2025

Type: article

Abstract: Disclosure: K.N. Andino-Lebrón: None. E.J. Sola Sanchez: None. M.M. Mangual Garcia: None. V. Maldonado Torres: None. M. Hernandez Hernandez: None. I.E. Hernandez Castro: None. N. Roman Velez: None. G.J. Mora Osoria: None. Graves’ disease is an autoimmune disorder characterized by thyrotoxicosis, ophthalmopathy, goiter, and dermopathy. It is thought to arise when an inciting event sensitizes T lymphocytes to thyroid antigens, stimulating B cells to produce TSH receptor antibodies. Viral infections have been proposed as potential triggers. Dengue fever, a mosquito-borne illness caused by the dengue virus and transmitted by Aedes aegypti or Aedes albopictus, typically presents with fever, myalgias, arthralgias, and rash, followed by a recovery phase.We report the case of a previously healthy 31-year-old female who developed Graves' disease following dengue fever. Three weeks post-recovery, she presented with palpitations, anxiety, fatigue, unintentional weight loss, and exophthalmos. Examination revealed tachycardia, tremors, exophthalmos, and an enlarged thyroid gland. Laboratory tests showed low TSH and elevated FT3 and FT4 (3:1 ratio), with positive TPO and TSI antibodies. Thyroid scintigraphy demonstrated a diffuse toxic goiter with 81.3% radioactive iodine uptake. She was diagnosed with Graves' disease and started on Methimazole. Two weeks later, her thyroid hormone levels normalized, but treatment was discontinued due to hepatotoxicity, and she was referred for total thyroidectomy.This case highlights the potential of dengue fever to precipitate autoimmune thyroid disease. While direct reports of Graves’ disease triggered specifically by dengue fever are rare, emerging evidence suggests that viral infections, including dengue, may trigger autoimmune processes. Cases of subacute thyroiditis during or following dengue fever have been documented, supporting the hypothesis that viral infections may play a role in thyroid autoimmunity. The presence of viral antigens can lead to aberrant expression of major histocompatibility complex class II molecules on thyrocytes, leading to the production of autoantibodies against the TSH receptor in genetically predisposed individuals. Further research is needed to confirm this association and explore the mechanisms underlying these interactions. Presentation: Saturday, July 12, 2025

Source: Journal of the Endocrine Society