Subacute thyroiditis after SARS-CoV-2 vaccination: a report of two sisters and summary of the literature

Chatzi, Sofia; Karampela, Athina; Spiliopoulou, Chara; Boutzios, Georgios

doi:10.1007/s42000-021-00332-z

Cited by 22 publications

(19 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…On the other hand, certain types of HLA (HLAB35) are considered for susceptibility to subacute thyroiditis, activation of the antigen-HLAB35 complex, leading to immune-mediated destruction of the thyroid follicular cells [ 53 ]. Interestingly, a report on two sisters who present subacute thyroiditis a few days after receiving a Covid-19 mRNA vaccine has been recently described [ 22 ], and the potential role of genetic predisposition remains to be investigated further. However, no potential risk factors (personal or familial autoimmune disease, pregnancy, post-partum) or predictors (smoking, stress, drugs, hypovitaminosis D) have been reported to have an influence on the occurrence of the majority of autoimmune or inflammatory thyroid diseases following SARS-CoV- 2 vaccination.…”

Section: Pathophysiological Mechanisms Of Thyroid Diseases After Sars...mentioning

confidence: 99%

Autoimmune and inflammatory thyroid diseases following vaccination with SARS-CoV-2 vaccines: from etiopathogenesis to clinical management

Caron

2022

Endocrine

View full text Add to dashboard Cite

Since the Covid-19 pandemic emerged in 2019, several adenoviral-vectored, mRNA-based and inactivated whole-virus vaccines have been developed. A massive vaccination campaign has been undertaken around the world, and an increasing number of SARS-CoV-2 vaccine-induced thyroid diseases have been described in the literature. Subacute thyroiditis has been reported in 52 patients, mean age 45.5 ± 1.8 years, mainly in women ( n = 39). Graves’ disease is more frequent in women ( n = 22) than in men ( n = 10), mean age 46.2 ± 2.6 years, reported as new onset, recurrent or exacerbation of well-controlled hyperthyroidism. The mean time to symptoms onset is 9.0 ± 0.8 days in subacute thyroiditis, and 15.1 ± 2.6 days in Graves’ patients. Rare patients ( n = 6) present silent or painless autoimmune thyroiditis. Thyroid function and autoimmune tests, inflammatory markers, thyroid echography with colour flow Doppler, radio-activity uptake on thyroid scan, medical treatment and follow-up are described and compared in patients with SARS-CoV-2 vaccine-induced thyroid diseases. The underlying pathogenic mechanisms of vaccine-induced thyroid diseases, molecular mimicry (various SARS-CoV-2 proteins sharing a genetic homology with a large heptapeptide human protein) or autoimmune/inflammatory syndrome induced by adjuvants (ASIA) are discussed in the context of predisposition or genetic susceptibility. The benefits of SARS-CoV-2 vaccination far outweigh the potential vaccine-induced adverse effects, but clinicians should be aware of possible autoimmune and inflammatory thyroid diseases, and can advise patients to seek medical assistance when experiencing anterior neck pain, fever or palpitations following SARS-CoV-2 vaccines. Further studies are warranted to investigate the etiopathogenesis and to clarify the factors which predispose patients to SARS-CoV-2 vaccine-induced thyroid diseases.

show abstract

Section: Pathophysiological Mechanisms Of Thyroid Diseases After Sars...mentioning

confidence: 99%

Autoimmune and inflammatory thyroid diseases following vaccination with SARS-CoV-2 vaccines: from etiopathogenesis to clinical management

Caron

2022

Endocrine

View full text Add to dashboard Cite

show abstract

“…SAT developed in 10 patients after inactivated COVID-19 vaccine (CoronaVac®, Sinovac Life Sciences, Beijing, China) and in six patients after the COVID-19 messenger RNA (mRNA) (Pfizer-BioNTech®) vaccination. The median duration of symptom onset after vaccination was 6.5 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) days. Baseline characteristics of the study population are depicted in Table 1.…”

Section: Characteristics Of the Study Populationmentioning

confidence: 99%

Evaluation of the diagnostic features and clinical course of COVID-19 vaccine–associated subacute thyroiditis

et al. 2022

View full text Add to dashboard Cite

Objective This study aimed to identify cases of coronavirus disease 2019 (COVID-19) vaccine-associated subacute thyroiditis (SAT) during the active vaccination period of the pandemic, analyze the characteristics of these cases, and compare them with cases of non-vaccine associated SAT diagnosed in the same period. Methods A total of 55 patients diagnosed with SAT in our outpatient clinic between February and October, 2021, were included in this retrospective single-center study. Results Of the study population, 16 (29.1%) were diagnosed with COVID-19 vaccine-associated SAT (10 with CoronaVac® and six with Pfizer-BioNTech® vaccine), with a median time to onset of symptoms after vaccination of 6.5 (range, 2-20) days. There was no statistically significant difference between the vaccine-associated (VA) and non-vaccine associated (NVA) groups in terms of age, gender, time to diagnosis, thyroid volumes, thyroid function tests, and acute phase reactants. Seven (43.8%) and 25 (64.1%) patients were treated with methylprednisolone in the VA group and NVA group, respectively (p = 0.16). Follow-up data of 45 patients (16/16 for VA and 29/39 for NVA) were available. The mean follow-up of these patients was 47.4 ± 19.4 days, and the follow-up periods of the VA group and NVA group were comparable (p = 0.24). There was no difference between the two groups in terms of the frequency of euthyroidism at the follow-up visit (12/16 vs.14/29, p = 0.08). Conclusion With the increase in COVID-19 vaccination rates during the current pandemic, VA SAT cases are seen more frequently. The present study demonstrated that these cases have similar diagnostic features and clinical course to that of classic forms of SAT. In addition, most patients with VA SAT had a mild clinical course that improved with non-steroidal anti-inflammatory drugs.

show abstract

“…SAT following COVID-19 vaccination has recently been reported [79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96]. Details in these 23 cases and the two present cases are summarized in Table 2.…”

Section: Discussionmentioning

confidence: 88%

Subacute thyroiditis with liver dysfunction following coronavirus disease 2019 (COVID-19) vaccination: report of two cases and a literature review

2022

View full text Add to dashboard Cite

Subacute thyroiditis is a transient inflammatory thyroid disease characterized by neck pain, fever, and typical symptoms associated with thyrotoxicosis. The incidence of subacute thyroiditis is higher in female than in male, and susceptibility is prominent in the 30-50-year age range. The variety of case reports on subacute thyroiditis associated with coronavirus disease 2019 (COVID-19) appears to be increasing, and subacute thyroiditis following COVID-19 vaccination has recently been reported. Herein, we report two cases of subacute thyroiditis that developed after receiving the COVID-19 mRNA vaccine, one of which exhibited remarkable liver dysfunction. The mechanism underlying the development of postvaccination subacute thyroiditis remains unknown; however, one theory suggests that adjuvants contained in vaccines may play a role in triggering diverse autoimmune and inflammatory responses. Another possibility is the potential cross-reactivity between the coronavirus spike protein target produced by the mRNA vaccine and thyroid cell antigens. Common side effects of the COVID-19 vaccine include pain at the injection site, fever, fatigue, headache, muscle pain, chills, and nausea. These symptoms are usually resolved within a few days. Subacute thyroiditis may present symptoms similar to those of short-term vaccination side effects or exhibit non-specific symptoms, potentially leading to misdiagnosis or underdiagnosis. Therefore, clinicians should be aware of the possible development of subacute thyroiditis after COVID-19 vaccination.

show abstract

Subacute thyroiditis after SARS-CoV-2 vaccination: a report of two sisters and summary of the literature

Cited by 22 publications

References 8 publications

Autoimmune and inflammatory thyroid diseases following vaccination with SARS-CoV-2 vaccines: from etiopathogenesis to clinical management

Autoimmune and inflammatory thyroid diseases following vaccination with SARS-CoV-2 vaccines: from etiopathogenesis to clinical management

Evaluation of the diagnostic features and clinical course of COVID-19 vaccine–associated subacute thyroiditis

Subacute thyroiditis with liver dysfunction following coronavirus disease 2019 (COVID-19) vaccination: report of two cases and a literature review

Contact Info

Product

Resources

About