Khan Farooq, Brassill Mary Jane
Department of Endocrinology, Tipperary University Hospital, Clonmel, Co. Tipperary, Ireland.
Endocrinol Diabetes Metab Case Rep. 2021 Dec 1;2021. doi: 10.1530/EDM-21-0142.
There is emerging evidence of an association between COVID-19 vaccination and subacute thyroiditis. We present the case of a 42-year-old female healthcare worker who was diagnosed with subacute thyroiditis 4 days after receiving her second dose of Pfizer-BioNTech vaccine. Her clinical course followed the classical pattern for thyroiditis with spontaneous return to euthyroidism at 6 months post-presentation. The autoimmune/inflammatory syndrome induced by adjuvants has been implicated as a cause of autoimmune conditions post-vaccination and is a potential mechanism for subacute thyroiditis in our case.
Subacute thyroiditis should be considered in all patients who receive any kind of vaccine for COVID-19 and subsequently develop symptoms or signs of hyperthyroidism or neck pain. Subacute thyroiditis is a self-limiting condition, and recognising it is important as no specific thyroid treatment (antithyroid drugs or thyroid hormone replacement) is necessary for most patients. The autoimmune/inflammatory syndrome induced by adjuvants may be an under-recognised cause of endocrinopathies and should particularly be considered post-vaccination.
越来越多的证据表明新冠病毒疫苗接种与亚急性甲状腺炎之间存在关联。我们报告了一例42岁的女性医护人员病例,她在接种第二剂辉瑞-BioNTech疫苗4天后被诊断为亚急性甲状腺炎。其临床病程遵循甲状腺炎的经典模式,发病后6个月甲状腺功能自发恢复正常。佐剂诱导的自身免疫/炎症综合征被认为是疫苗接种后自身免疫性疾病的一个原因,也是我们病例中亚急性甲状腺炎的潜在机制。
所有接种任何新冠病毒疫苗后出现甲状腺功能亢进症状或体征或颈部疼痛的患者都应考虑亚急性甲状腺炎。亚急性甲状腺炎是一种自限性疾病,认识到这一点很重要,因为大多数患者不需要特殊的甲状腺治疗(抗甲状腺药物或甲状腺激素替代治疗)。佐剂诱导的自身免疫/炎症综合征可能是一种未被充分认识的内分泌病病因,尤其应在疫苗接种后予以考虑。