Subacute thyroiditis after SARS-CoV-2 BNT162b2 vaccine in a multiple myeloma patient

Abstract

Viral infections emerge in the pathogenesis of subacute thyroiditis. Aside from this, subacute thyroiditis following vaccines utilizing inactivated viruses has been shown on rare occasions. Due to the COVID-19 pandemic, several vaccines have been developed all over the world; mass and unprecedented vaccination has thus been initiated. However, it is known that cases such as subacute thyroiditis have been reported, albeit rarely, after administration of COVID-19 vaccines. In this case report, we present a 59-year-old patient with multiple myeloma developing subacute thyroiditis following BNT162b2 vaccine. Patient had swelling in the neck, and his symptoms were controlled with non-steroidal anti-inflammatory drugs. Subacute thyroiditis following administration of the COVID-19 vaccine is rare; however, it is likely an under-reported condition that is difficult to detect. Clinicians should stay informed and have increased awareness of post-COVID-19 vaccine subacute thyroiditis.

The Old and the New in Subacute Thyroiditis: An Integrative Review

“…For instance, SAT cases associated with bacterial infection (bacterial sinusitis [23], scrub typhus [24]), or with immunotherapy with recombinant interleukin-2 [25], TNF-alpha inhibitors [26], interferon [27], or lithium treatment [28] have been described. SAT cases occurring after vaccination against common viruses such as H1N1 [29], seasonal influenza virus [30,31], human papillomavirus [32,33], and hepatitis B [34] have been reported; since the advent of the vaccination for SARS-CoV-2, several SAT cases following immunization have been described [18], following the nucleic acid (mRNA) [35], viral vector (adenovirus) [36], and the inactivated virus vaccine [37,38]. The exact mechanism is not known, but the presumed pathogenesis of SAT after vaccinations may involve the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) [39], an immune reaction triggered by a class of excipients named adjuvants, primarily used in vaccines, which could cause dysregulation of both the innate and adaptive immune systems [40].…”