Annals of Case Reports and Clinical Studies (ISSN: 2834-5673) | Volume 5, Issue 5 | Case Report | Open Access DOI
Shaun Nevil*
Aditi Balan1, Pragna Yandrathi2, Ishant Aggarwal3, Pranjal Patil4, S Anton Charles5, Shaun Nevil6*, Chaitra C S7
1ACS Medical College and Hospital, Chennai, Tamil Nadu, India
2Common Wealth University College of Medicine, St. Lucia, India
3All India Institute of Medical Sciences, Gorakhpur, India
4Dr. Vaishampayan Memorial Government Medical College, Solapur, Maharashtra, India
5Department of Internal Medicine, ESIC Medical College PGIMSR & Model Hospital, Bengaluru, India
6Department of Internal Medicine, ESIC Medical College PGIMSR & Model Hospital, Bengaluru, India
7Department of Internal Medicine, ESIC Medical College PGIMSR & Model Hospital, Bengaluru, India
*Correspondence to: Shaun Nevil
Fulltext PDFAutoimmune thyroid disease and rheumatoid arthritis (RA) share overlapping immunogenetic pathways, but their simultaneous, fulminant onset is rarely reported and can be mistaken for sepsis. A 68-year-old previously healthy woman presented with fever, chills, polyarthralgia, and an irregular pulse of 160 beats/min, initially diagnosed as urinary sepsis with hyponatremia. Work-up revealed suppressed thyroid-stimulating hormone (TSH) with elevated free T3/T4 and atrial fibrillation with fast ventricular response, alongside positive anti-cyclic citrullinated peptide antibody, rheumatoid factor, and elevated erythrocyte sedimentation rate, confirming synchronous thyrotoxicosis and seropositive RA. She improved with rate control, anticoagulation, carbimazole, and disease-modifying antirheumatic drugs (DMARDs). Autoimmune emergencies can closely mimic infection, a high index of suspicion and multidisciplinary management are essential to prevent cardiovascular and metabolic decompensation.
Aditi Balan, Pragna Yandrathi, Ishant Aggarwal, Pranjal Patil, S Anton Charles, Shaun Nevil, et al. Concurrent Thyrotoxicosis-Induced Atrial Fibrillation and Seropositive Rheumatoid Arthritis Masquerading as Urinary Sepsis: A Case Report. Ann Case Rep Clin Stud. 2026;5(5):1-4.