CASE REPORT article
Front. Med.
Sec. Infectious Diseases: Pathogenesis and Therapy
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1644656
Case report: SARS-CoV-2-associated immune dysfunction manifesting as concurrent fulminant type 1 diabetes mellitus and subacute thyroiditis
Provisionally accepted
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Objectives: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.Case Presentation: 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 β -cell function remained absent, necessitating lifelong insulin therapy.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.
Keywords: SARS-CoV-2 infection, Fulminant type 1 diabetes mellitus, subacute thyroiditis, cytokine stormsm, Immune injury
Received: 11 Jun 2025; Accepted: 30 Jul 2025.
Copyright: © 2025 Fang, Wang, Zhong, Xu and Zhu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Huanping Wang, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.