Pandya Manthan, Thota Geethika, Wang Xiangbing, Luo Hongxiu
Division of Endocrinology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey.
Division of Endocrinology, Saint Peter University Hospital, New Brunswick, New Jersey.
AACE Clin Case Rep. 2022 May-Jun;8(3):116-118. doi: 10.1016/j.aace.2021.12.002. Epub 2021 Dec 16.
Although SARS-CoV-2 virus infection has been reported to cause subacute thyroiditis, the mRNA vaccine for SARS-CoV-2 is suspected to induce thyroiditis with thyrotoxicosis.
: We describe 3 patients with no history of thyroid disease who presented with symptomatic, biochemical, and radiological evidence of thyroiditis with thyrotoxicosis, 10 to 20 days after receiving either Pfizer Bio-NTech or Moderna COVID-19 mRNA vaccines. All patients presented with thyrotoxicosis but with negative thyroid-stimulating immunoglobulins for Graves disease and no autonomous nodules. Two patients underwent thyroid uptake scans that confirmed thyroiditis. One patient had significantly increased erythrocyte sedimentation rate and interleukin-6. All patients showed improvement in symptoms with nonsteroidal anti-inflammatory drugs, and 1 patient eventually required steroids for symptom control.
The mRNA vaccine for SARS-CoV-2 was associated with thyroiditis and led to thyrotoxicosis. Elevated proinflammatory markers and cytokines after vaccines may play a major role.
Our case series report highlights a possible relationship between the COVID-19 mRNA vaccine and thyroiditis with thyrotoxicosis, which has not been recognized by health providers.
尽管已有报告称严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染可导致亚急性甲状腺炎，但怀疑SARS-CoV-2的信使核糖核酸（mRNA）疫苗会诱发甲状腺毒症伴甲状腺炎。
我们描述了3例无甲状腺疾病史的患者，他们在接种辉瑞Bio-NTech或莫德纳COVID-19 mRNA疫苗后10至20天，出现了甲状腺毒症伴甲状腺炎的症状、生化及影像学证据。所有患者均表现为甲状腺毒症，但格雷夫斯病的促甲状腺素受体抗体呈阴性，且无自主性结节。2例患者接受了甲状腺摄取扫描，证实为甲状腺炎。1例患者的红细胞沉降率和白细胞介素-6显著升高。所有患者使用非甾体抗炎药后症状均有改善，1例患者最终需要使用类固醇来控制症状。
SARS-CoV-2的mRNA疫苗与甲状腺炎有关，并导致甲状腺毒症。疫苗接种后促炎标志物和细胞因子升高可能起主要作用。
我们的病例系列报告突出了COVID-19 mRNA疫苗与甲状腺毒症伴甲状腺炎之间可能存在的关系，而这一点尚未被医疗服务提供者所认识。
