Painful goiter with persistent fever: a Graves' disease mimicking subacute thyroiditis

Graves’ disease is frequent in young women and is usually featured as thyrotoxicosis with vascular and painless goiter. We report the case of 41-year-old woman presented with persistent fever and severe painful goiter with raised C-reactive protein levels mimicking a subacute thyroiditis. Scintigraphic features and elevated thyroid-stimulating hormone receptor antibodies levels were suggestive of Graves’ disease. The occurrence of a hepatic toxicity on methimazole led to total thyroidectomy and histological exam confirmed the Graves’ disease diagnosis and excluded all other possible causes of painful goiter.