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接种 SARS-CoV-2 mRNA 疫苗后发生 1 型糖尿病。

Type 1 diabetes mellitus following SARS-CoV-2 mRNA vaccination.

机构信息

Department of Endocrinology and Metabolism, Ankara Güven Hospital, Ankara, Turkey.

Department of Internal Medicine, Division of Endocrinology and Metabolism, Hacettepe University School of Medicine, Ankara, Turkey.

出版信息

Endocrine. 2022 Oct;78(1):42-46. doi: 10.1007/s12020-022-03130-8. Epub 2022 Jul 9.

Abstract

PURPOSE

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been reported to trigger immune side effects. Type 1 diabetes as a manifestation of autoimmune/inflammatory syndrome induced by adjuvants has been reported in a limited number of cases after vaccinations. A few type 1 diabetes cases after SARS-CoV-2 vaccination have been reported. This study aims to report type 1 diabetes cases associated with the mRNA-based SARS-CoV-2 vaccination.

METHODS

We report four cases of type 1 diabetes mellitus after mRNA-based SARS-CoV-2 vaccine, BNT162b2 (Pfizer-BioNTech). In the medical history, one subject had autoimmune thyroid disease. All patients had autoantibodies against glutamate decarboxylase.

RESULTS

In the presented case series, type 1 diabetes developed a few weeks after BNT162b2 vaccination. After developing type 1 diabetes, the insulin dose requirements of all patients decreased rapidly, and the need for insulin therapy in three patients disappeared during follow-up. Acute deterioration of glucose regulation in a patient followed by BNT162b2 administration may be due to vaccine-induced autoimmune diabetes.

CONCLUSION

Vaccination with BNT162b2 may trigger type 1 diabetes.

摘要

目的

据报道,严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)疫苗会引发免疫副作用。在接种疫苗后,有限数量的病例报告了表现为佐剂诱发的自身免疫/炎症综合征的 1 型糖尿病。也有少数接种 SARS-CoV-2 疫苗后发生 1 型糖尿病的病例报告。本研究旨在报告与基于 mRNA 的 SARS-CoV-2 疫苗接种相关的 1 型糖尿病病例。

方法

我们报告了 4 例接受基于 mRNA 的 SARS-CoV-2 疫苗(BNT162b2,辉瑞-生物科技)后发生 1 型糖尿病的病例。在病史中,有 1 名患者患有自身免疫性甲状腺疾病。所有患者均存在谷氨酸脱羧酶自身抗体。

结果

在本病例系列中,BNT162b2 接种后数周内发生 1 型糖尿病。发生 1 型糖尿病后,所有患者的胰岛素剂量需求迅速下降,3 名患者在随访期间胰岛素治疗需求消失。一名患者在接受 BNT162b2 治疗后出现血糖调节急剧恶化,可能是疫苗诱导的自身免疫性糖尿病所致。

结论

接种 BNT162b2 可能会引发 1 型糖尿病。

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Endocrine. 2022 Oct;78(1):42-46. doi: 10.1007/s12020-022-03130-8. Epub 2022 Jul 9.

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