Abstract：
Subacute thyroiditis (also known as granulomatous thyroiditis, giant cell thyroiditis, de Quervain\'s disease, or SAT) is an inflammatory disease of the thyroid gland, usually spontaneously remitting, that lasts for weeks to months. However, recurrent forms sometimes occur which may have a genetic basis. In our paper, we have focused on the pathogenetics, symptoms, and treatment of SAT. We have described the 17-month disease course of a woman with persistent recurrent steroid-resistant SAT. SAT was well established and the patient\'s symptoms were not only recurrent neck pain with fever, but also recurrent chronic urticaria, which are symptoms that fulfil the criteria for the diagnosis of Schnitzler syndrome. Schnitzler syndrome occurred after vaccination with COVID-19 in the mechanism of ASIA syndrome. In our patient, Schnitzler syndrome involved the thyroid gland, causing persistent subacute thyroiditis, and the pituitary gland, causing transient swelling of the pituitary, which, to our knowledge, is the first reported case in the literature. Also unprecedented, as far as we know, is the fact that we performed thyroidectomy in the above patient, which reduced systemic inflammation and caused SAT to resolve, although only the inclusion of anakinra treatment resulted in resolution of the underlying condition.
摘要：
亚急性甲状腺炎（也称为肉芽肿性甲状腺炎，巨细胞甲状腺炎,deQuervain病,或SAT）是甲状腺的炎症性疾病，通常是自发的，持续数周至数月。然而,有时会出现复发形式，这可能有遗传基础。在我们的论文中,我们关注的是发病机理,症状,和SAT的治疗。我们已经描述了患有持续性复发性类固醇抗性SAT的女性的17个月病程。SAT已确立，患者的症状不仅是反复出现的颈部疼痛伴发热，还会反复发作的慢性荨麻疹,这些症状符合Schnitzler综合征的诊断标准。在ASIA综合征的机制中接种COVID-19后发生Schnitzler综合征。在我们的病人身上，Schnitzler综合征涉及甲状腺，导致持续性亚急性甲状腺炎,和脑垂体,导致垂体短暂肿胀，which,根据我们的知识，是文献中第一例报道的病例。也是前所未有的，据我们所知,我们对上述患者进行了甲状腺切除术，减少全身性炎症并导致SAT消退，尽管只有包括anakinra治疗才能解决基础疾病。
