A Case Report of Concurrent Graves' Disease and Subacute Thyroiditis Following SARS-CoV-2 Vaccination: An Autoimmune/Inflammatory Syndrome (ASIA)

• Published in: Endocrine, metabolic & immune disorders drug targets Vol. 23; no. 2; p. 242
• Main Authors: Taşkaldıran, Işılay, Altay, Feride Pınar, Bozkuş, Yusuf, İyidir, Özlem Turhan, Nar, Aslı, Tütüncü, Neslihan Başçıl
• Format: Journal Article
• Language: English
• Published: United Arab Emirates 01-02-2023
• Subjects: Adult; BNT162 Vaccine; COVID-19 - complications; COVID-19 - diagnosis; COVID-19 Vaccines - adverse effects; Female; Graves Disease - complications; Humans; SARS-CoV-2; Thyroiditis, Subacute - complications; Thyroiditis, Subacute - etiology; Vaccination - adverse effects; COVID-19; subacute thyroiditis; vaccine; SARS CoV-2; ASIA; Graves’ disease
• ISSN: 2212-3873
• DOI: 10.2174/1871530322666220621101209

The response against adjuvants in vaccines is presented as autoimmune/inflammatory syndrome (ASIA). In this case report, we presented both SAT and Graves' disease in a patient as ASIA following the BNT162b2 mRNA COVID-19 vaccination.
A 31-year-old woman was admitted to the endocrinology outpatient clinic with the complaint of neck pain following the second dose of the BNT162B2 SARS-CoV-2 (Pfizer/BioNTech) vaccine. On physical examination, her thyroid gland was tender on palpation. Her thyroid function tests were compatible with hyperthyroidism, and inflammatory markers were high. In the thyroid ultrasonography (US) examination, we observed bilateral diffuse hypoechoic areas in the thyroid gland and increased vascularity in some parts of the thyroid. Anti-thyroid stimulating hormone receptor antibodies (TRAB) were positive. Overall, we considered concurrent subacute thyroiditis (SAT) and Graves' disease.
The present study may be the first report to evaluate SAT and Graves' disease as ASIA following mRNA COVID-19 vaccination. Clinicians should be aware of possible vaccine-related complications.