Department of General, Visceral, Cancer and Transplant Surgery, University Clinic of Cologne, Cologne, Germany.
Policlinic for Endocrinology, Diabetes and Prevention Medicine, University Clinic of Cologne, Cologne, Germany.
Endocr Regul. 2022 Jul 13;56(3):227-231. doi: 10.2478/enr-2022-0024.
The present study evaluates the occurrence of subacute thyroiditis in temporal connection with SARS-Cov2 vaccinations described in the literature last year and confirmed by our clinical routine. Systematic literature search in Medline for studies reporting diagnosis of subacute thyroiditis in temporal connection with vaccinations against Covid 19. The literature search yielded 24 relevant references out of which 22 were "case reports" and two "Letters to the Editor" and encompassed 37 patient cases, in total. They had received a SARS-Cov2 vaccination shortly before the diagnosis (median interval to vaccination six days). In none of these cases, infection of the upper respiratory tract had previously been identified as a classic trigger of the disease. Newly occurring hyperthyroidism and increased laboratory signs of inflammation were described in 78% and 74% of cases, respectively. Atypical clinical pictures (asymptomatic, euthyroid, no inflammation marks) have been observed in both the literature and our patients suspected of thyroid cancer referred to surgery. In times of pandemics and the resulting vaccination, new rapidly occurring sonographic changes in the thyroid gland should be revaluated after 2-3 weeks, or recommended to undergo a fine-needle biopsy, in order to avoid unnecessary surgical interventions.
本研究评估了去年文献中描述的与 SARS-CoV-2 疫苗接种相关的亚急性甲状腺炎的发生情况，并通过我们的临床常规得到了证实。在 Medline 中进行系统的文献检索，以查找报告与接种 COVID-19 疫苗有时间关联的亚急性甲状腺炎诊断的研究。文献检索共得到 24 篇相关参考文献，其中 22 篇为“病例报告”，2 篇为“给编辑的信”，共涉及 37 例患者。他们在诊断前不久接种了 SARS-CoV-2 疫苗（接种至发病的中位间隔为 6 天）。在这些病例中，没有一例先前被确定为上呼吸道感染为该病的经典诱因。新出现的甲状腺功能亢进和实验室炎症标志物升高分别在 78%和 74%的病例中被描述。在文献和我们怀疑患有甲状腺癌而转诊手术的患者中，都观察到了典型的临床症状（无症状、甲状腺功能正常、无炎症标志物）。在大流行期间以及由此产生的疫苗接种中，对于甲状腺内新出现的快速超声变化，应在 2-3 周后重新评估，或建议进行细针活检，以避免不必要的手术干预。
