Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan.
School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Ocul Immunol Inflamm. 2023 Aug;31(6):1286-1290. doi: 10.1080/09273948.2023.2176889. Epub 2023 Feb 16.
A 51-year-old male had a history of well-controlled Graves' disease (GD) under regular follow-up, and thyroid eye disease (TED) with post bilateral orbital decompression. However, after COVID-19 vaccination, recrudescence of GD and moderate-to-severe TED were diagnosed by increased thyroxine levels and decreased thyrotropin levels in serum, and positive results of thyrotropin receptor antibody and thyroid peroxidase antibody. Weekly intravenous methylprednisolone was prescribed. Symptoms gradually improved accompanied with reduction in proptosis: 1.5 mm of the OD and 2.5 mm of the OS. Possible pathophysiological mechanisms discussed included molecular mimicry theory, autoimmune/inflammatory syndrome induced by adjuvants, and certain genetic predisposition of human leukocyte antigen. Physicians should remind patients to seek treatment if the symptoms and signs of TED recur following COVID-19 vaccination.
一位 51 岁男性，患有 Graves 病（GD），病情控制良好，一直在定期随访中，并且患有甲状腺眼病（TED），曾行双侧眼眶减压术。然而，在 COVID-19 疫苗接种后，他出现 GD 复发和中重度 TED，表现为血清中甲状腺素水平升高和促甲状腺素水平降低，促甲状腺素受体抗体和甲状腺过氧化物酶抗体阳性。给予每周静脉注射甲基强的松龙。随着眼球突出度的降低，症状逐渐改善：右眼 1.5 毫米，左眼 2.5 毫米。讨论的可能病理生理学机制包括分子模拟理论、佐剂诱导的自身免疫/炎症综合征，以及人类白细胞抗原的某些遗传易感性。如果 COVID-19 疫苗接种后 TED 的症状和体征复发，医生应提醒患者寻求治疗。
