Subacute Thyroiditis Secondary to Moderna COVID-19 Vaccine: A Case Report of a Rare Manifestation

Patel, Mayank; Shahid, Marika; Khawaja, Ahmad; Ejike, Chibuzor; Vemuri, Kavitha

doi:10.53785/2769-2779.1019

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…Diagnosis is usually performed by clinical features, laboratory findings, and ultrasound, whereas fine needle aspiration is reserved for selected cases to differentiate it from a thyroid neoplasm [ 5 ]. SARS-CoV-2 infection can act as a trigger for subacute thyroiditis [ 24 ], and a few cases of subacute thyroiditis were also reported after the SARS-CoV-2 vaccine [ 16 , 17 , 18 , 19 , 20 , 21 , 22 ], also referred to as ASIA syndrome [ 16 ]. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is responsible for numerous autoimmune disorders such as systemic lupus erythematosus, rheumatoid arthritis, or autoimmune endocrinopathies such as Hashimoto and subacute thyroiditis.…”

Section: Discussionmentioning

confidence: 99%

“…This syndrome was sometimes referred to as autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome) [ 14 ]. Recent studies described cases of patients presenting with subacute thyroiditis after the inoculation of various types of vaccines against SARS-CoV-2, both inactivated, recombinant or mRNA based [ 16 , 17 , 18 , 19 , 20 , 21 , 22 ]. Here, we present a case of a woman developing De Quervain’s thyroiditis following the first dose of mRNA vaccine against SARS-CoV-2 “Comirnaty” by Pfizer Inc. (New-York, USA).…”

Section: Introductionmentioning

confidence: 99%

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Vaccine-Induced Subacute Thyroiditis (De Quervain’s) after mRNA Vaccine against SARS-CoV-2: A Case Report and Systematic Review

Pipitone

Rindi

Petrosillo

et al. 2022

Infectious Disease Reports

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De Quervain’s thyroiditis, sometimes referred to as subacute thyroiditis (SAT), is the most common granulomatous disease of the thyroid, typically found after a viral infection in middle-aged women. The mRNA encoding for the angiotensin-converting enzyme-2 (ACE-2) receptor is expressed in follicular thyroid cells, making them a potential target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Besides infection, SARS-CoV-2 vaccines have also been implicated in SAT pathogenesis. We present a case of a woman developing SAT following vaccination with Comirnaty by Pfizer Inc. (New-York, USA). We performed a systematic review of similar cases available in the literature to provide a better understanding of the topic. We searched the databases PubMed and Embase and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Patient records were then sorted according to the type of administered vaccine and a statistical analysis of the extracted data was performed. No statistically significant difference between mRNA vaccines and other vaccines in inducing SAT was found, nor was any found in terms of patient demographics, symptoms at presentation, initial, or follow-up blood tests. In our case report, we described the possible association between SARS-CoV-2 mRNA-based vaccine Comirnaty and SAT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Vaccine-Induced Subacute Thyroiditis (De Quervain’s) after mRNA Vaccine against SARS-CoV-2: A Case Report and Systematic Review

Pipitone

Rindi

Petrosillo

et al. 2022

Infectious Disease Reports

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“…It has been hypothesized that vaccinations may be responsible for producing an immune response that triggers thyroid inflammation in predisposed patients. Another hypothesis includes the SARS-CoV-2 spike protein, nucleoprotein, and membrane protein which cross-reacts with thyroid peroxidase [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Thyroiditis after mRNA Vaccination for COVID-19

Saha

Chittimoju

Trivedi

2022

Case Reports in Endocrinology

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Background. SARS-CoV-2 has been known to cause multisystemic involvement, gaining entry through ACE-2 and TMPRSS2 receptors. COVID-19 vaccine-associated thyroiditis cases are now being reported. Case Report. Case 1. A 36-year-old woman with a history of right hemithyroidectomy for a benign thyroid nodule, on a stable dose of levothyroxine with euthyroid labs, presented with progressively worsening left neck pain, episodic palpitations, and heat intolerance after the second dose of mRNA1273 (Moderna) vaccine. Examination revealed an enlarged and tender left lobe of the thyroid with suppressed TSH but normal free T4 and ESR, signifying subacute thyroiditis. She was managed conservatively without corticosteroids or beta-blockers, and her symptoms resolved. A follow-up revealed increasing TSH, and levothyroxine was restarted. Case 2. A 33-year-old man with a history of anxiety disorder on Sertraline, presented with a two-week history of palpitations, heat intolerance, and 10-pound weight loss after the second dose of BNT162b2 (Pfizer-BioNTech) vaccine. Examination revealed a normal thyroid gland with no tenderness with elevated thyroid peroxidase and thyroglobulin antibodies. Ultrasound showed a diffusely heterogeneous thyroid with increased vascularity, suggesting silent thyroiditis. Follow-up revealed a hypothyroid phase with high TSH for which levothyroxine supplementation was started. Discussion. COVID-19 vaccine-associated subacute and silent thyroiditis have occurred following all three kinds of available vaccines, characterized by an initial thyrotoxic phase, followed by a hypothyroid phase and a recovery phase. Hypotheses include an immune response triggering thyroid inflammation or cross-reactivity with viral proteins. Conclusions. COVID-19 vaccine-associated thyroiditis is rare, but long-term monitoring of these patients is essential to ensure appropriate diagnosis and management of the potential hypothyroid phase.

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

et al. 2022

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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.

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Subacute Thyroiditis Secondary to Moderna COVID-19 Vaccine: A Case Report of a Rare Manifestation

Cited by 3 publications

References 2 publications

Vaccine-Induced Subacute Thyroiditis (De Quervain’s) after mRNA Vaccine against SARS-CoV-2: A Case Report and Systematic Review

Vaccine-Induced Subacute Thyroiditis (De Quervain’s) after mRNA Vaccine against SARS-CoV-2: A Case Report and Systematic Review

Thyroiditis after mRNA Vaccination for COVID-19

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

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