Four cases of Graves’ disease following viral vector severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) vaccine

Chaudhary, Shakun; Dogra, Vinay; Walia, Rama

doi:10.1507/endocrj.ej22-0208

Cited by 11 publications

(10 citation statements)

References 17 publications

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“…According to literature, most of those patients found symptoms relieved following anti-thyroid drug (ATD) treatment [ 34 , 35 , 37 – 39 ]. It is worth noting that 3 female patients (Cases 8, 9, and 11) developed hyperthyroidism symptoms after the first COVID-19 mRNA vaccine dose and were diagnosed as new-onset GD [ 35 ], as another 2 female patients (Cases 42 and 44) after the first COVID-19 viral vector vaccine dose did [ 60 ]. These patients had also received their second doses of COVID-19 vaccines when their conditions stabilized post-ATD treatment.…”

Section: Methodsmentioning

confidence: 99%

“…These patients had also received their second doses of COVID-19 vaccines when their conditions stabilized post-ATD treatment. Their conditions did not worsen or require adjusting the doses of ATD and beta-blocker after receiving the second doses [ 35 , 60 ]. Filippo et al [ 65 ] conducted a case–control study and found that among 64 patients who developed new-onset GD after COVID-19 vaccination, and 20/64 (31.2%) patients experienced post-vaccine early-onset GD (PoVEO) within 4 weeks.…”

Section: Methodsmentioning

confidence: 99%

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New-onset and relapsed Graves’ disease following COVID-19 vaccination: a comprehensive review of reported cases

Chen

Gao

2023

Eur J Med Res

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Global Coronavir us disease 2019 (COVID-19) vaccination efforts are being intensified to combat the pandemic. As the frequency of immunization against COVID-19 has increased, some adverse effects related to vaccination have emerged. Within this context, this article reviewed 62 Graves’ disease (GD) cases following COVID-19 vaccination, to probe the potential association between the vaccination and the onset of GD. A comprehensive search of the PubMed, Web of Science, and Scopus databases was conducted to collect GD cases following COVID-19 vaccination up to June 7, 2023. Among the 62 GD cases included in this review, there were 33 (53.2%) new-onset GD and 10 (16.1%) relapsed GD patients following mRNA vaccination, 14 (22.6%) new-onset GD and 4 (6.5%) relapsed GD patients following viral vector vaccination, and 1 (1.6%) relapsed GD patients following inactivated vaccination. Median durations to symptoms onset for new-onset and relapsed GD were 12 (range: 1–60) and 21 (range: 5–30) days following mRNA vaccination, while 7 (range: 1–28) and 14 (range: 10–14) days following viral vector vaccination, respectively. While the definitive pathogenesis of GD following COVID-19 vaccination remains unclear, it might be associated with cross-immune responses triggered by molecular mimicry, and an adjuvant-induced autoimmune/inflammatory syndrome. However, due to the limited number of observed GD cases following COVID-19 vaccination and the lack of systematic experimental studies, a causal relationship between COVID-19 vaccination and the onset of GD has not been definitively confirmed. It should be highlighted that most of GD patients following COVID-19 vaccination experienced positive outcomes after treatment. In the broader context of ending the COVID-19 pandemic and reducing mortality rates, the benefits of COVID-19 vaccination significantly outweigh mild risks such as treatable GD. Adherence to the COVID-19 vaccination schedule is therefore imperative in effectively managing the pandemic.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

New-onset and relapsed Graves’ disease following COVID-19 vaccination: a comprehensive review of reported cases

Chen

Gao

2023

Eur J Med Res

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“…To date, TED following SARS-CoV-2 vaccination has been reported in 23 patients [7][8][9][10][17][18][19][20][21][22][23], 16 of which were women (69.6%) and 7 men (30.4%), with a median age of 50 years [IQR 43-59] (Table 1). Of note, 8 out of the 23 patients (34.7%) had a personal history of autoimmunity.…”

Section: Review Of the Literaturementioning

confidence: 99%

“…Thyroid eye disease (TED) is an extrathyroidal manifestation of GD and is a very rare complication following COVID-19 vaccination; only a few cases have been reported in the literature [7][8][9]. All of the reported TED cases followed mRNA-based vaccinations [7], but two new onset mild TED cases post-viral vector vaccine (ChAdox1nCoV- 19) have also been reported [10].…”

Section: Introductionmentioning

confidence: 99%

Thyroid Eye Disease as Initial Manifestation of Graves’ Disease Following Viral Vector SARS-CoV-2 Vaccine: Report of a Case and Review of the Literature

Armeni,

Markantes,

Stathopoulou

et al. 2023

Vaccines

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COVID-19, a contagious disease caused by the novel coronavirus SARS-CoV-2, emerged in 2019 and quickly became a pandemic, infecting more than 700 million people worldwide. The disease incidence, morbidity and mortality rates have started to decline since the development of effective vaccines against the virus and the widespread immunization of the population. SARS-CoV-2 vaccines are associated with minor local or systemic adverse reactions, while serious adverse effects are rare. Thyroid-related disorders have been reported after vaccination for COVID-19, and Graves’ disease (GD) is the second most common amongst them. Thyroid eye disease (TED), an extrathyroidal manifestation of GD, is rarely observed post-COVID-19 vaccination. All TED cases followed mRNA-based vaccinations, but two new onset mild TED cases post-viral vector vaccine (ChAdox1nCoV-19) have also been reported. We report the case of a 63-year-old woman who presented with new onset hyperthyroidism and moderate-to-severe and active TED 10 days after she received the first dose of a viral vector vaccine against SARS-CoV-2. This is the first case of moderate-to-severe TED after such a vaccine. Our patient was initially treated with intravenous glucocorticoids, and subsequently with intravenous rituximab, due to no response. The disease was rendered inactive after rituximab, but constant diplopia persisted, and the patient was referred for rehabilitative surgery.

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“…Therefore, the knowledge on risk factors associated with GD and GO development seems to be crucial for the prevention and management of GO. Many environmental agents were demonstrated to be potential GD-triggering factors, including viral infections, vaccines ( 8 ), drugs ( 9 ), stress ( 5 ), reactive oxygen species (ROS) overproduction ( 10 ). Smoking, high serum TRAb levels, severe or unstable hyperthyroidism as well as hypercholesterolemia are already known risk factors of GO development and progression ( 7 , 11 ).…”

Section: Introductionmentioning

confidence: 99%

Significance of HLA in Graves’ disease and Graves’ orbitopathy in Asian and Caucasian populations – a systematic review

Stasiak,

Zawadzka-Starczewska

et al. 2023

Front. Immunol.

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IntroductionGraves’ disease (GD) and Graves’ orbitopathy (GO) development were suspected to be HLA-related in both Asian and Caucasian populations. However, most studies were performed with application of serological methods or low resolution genetic typing, which led to inconsistent results even among the same population. The present review is intended to summarize the state-of-art knowledge on the HLA significance in GD and GO in Asians and Caucasians, as well as to find the most significant alleles for each of the populations. MethodsPubMed was searched for relevant articles using the following search terms: HLA plus thyroid-associated ophthalmopathy or Graves’ disease or Graves’ orbitopathy or thyroid eye disease or thyroid-associated orbitopathy. ResultsIn Asian population GD was found to be associated mostly with B*46:01, DPB1*05:01, DRB1*08:02/03, DRB1*16:02, DRB1*14:03, DRB1*04:05, DQB1*05:02 and DQB1*03:03, while DRB1*07:01, DRB1*01:01, DRB1*13:02, DRB1*12:02 are potentially protective. HLA-B*38:02, DRB1*16:02, DQA1*01:02, DQB1*05:02 can be considered associated with increased risk of GO in Asians, while HLA-B*54:01 may play protective role. In Caucasians, C*07:01, DQA1*05:01, DRB1*03, DQB1*02:01 are associated with GD risk while DRB1*07:01, DQA1*02:01 may be protective. Significance of HLA in the course of GD and novel aspects of HLA amino acid variants and potential HLA-based treatment modalities were also discussed.

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Four cases of Graves’ disease following viral vector severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) vaccine

Cited by 11 publications

References 17 publications

New-onset and relapsed Graves’ disease following COVID-19 vaccination: a comprehensive review of reported cases

New-onset and relapsed Graves’ disease following COVID-19 vaccination: a comprehensive review of reported cases

Thyroid Eye Disease as Initial Manifestation of Graves’ Disease Following Viral Vector SARS-CoV-2 Vaccine: Report of a Case and Review of the Literature

Significance of HLA in Graves’ disease and Graves’ orbitopathy in Asian and Caucasian populations – a systematic review

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