October - December 2022, Volume 18, Issue 4

Hepsen S, Saat H, Akhanli P, Cakal E

The Management of Repetitive Subacute Thyroiditis in a Male Patient Having HLA-B35:01 and B41:02 Alleles

Acta Endo (Buc) 2022, 18 (4): 512-515
doi: 10.4183/aeb.2022.512

Context. Subacute thyroiditis (SAT) is an inflammatory disease of the thyroid gland and commonly affects females. Despite adequate treatment, the recurrence of SAT can be seen in some patients. Although there is insufficient data about the reasons for recurrences, HLA predisposition is one of the reasons thought to be responsible and is a current issue for clinicians. Objective. This case report presented the management of 7 SAT attacks of a patient who had HLA-B35:01 and B41:02 alleles in the genotype analysis. Case Report. A 37-year-old male patient who had consecutive 7 SAT attacks was presented in this report. Corticosteroid or non-steroidal anti-inflammatory drugs were initiated at each recurrence depending on the severity of clinical symptoms and laboratory findings. The genotype analysis showed the positivity for HLA-B35:01 and B41:02 alleles. The anti-thyroglobulin antibody was detected positive after the last attack. The patient was followed up as asymptomatic and euthyroid in the third month after the last attack. Results. The management of some SAT cases may be challenging for clinicians. Although recurrence can be seen despite adequate treatment, repetitive seven attacks are extraordinary in SAT. HLA genotyping showed cooccurrence of HLA-B35:01 and B41:02 alleles in our patient. The co-occurrence of these alleles has been described firstly in this case. Explaining high recurrence rates of SAT with these HLA alleles is difficult, though the present case may shed light on further studies.

Keywords: subacute thyroiditis, HLA genotype, HLA B35, HLA B41, recurrence

Correspondence: Sema Hepsen MD, University of Health Sciences, Diskapi Yildirim Beyazit Traning and Research Hospital, Endocrinology and Metabolism, Sehit Omer Halisdemir Street, Ankara, 06010, Turkey, E-mail: semahepsen@gmail.com