New-onset Thyroid Eye Disease after COVID-19 Vaccination in a Radioactive Iodine-Treated Graves’ Disease Patient

A Case Report and Literature Review

Authors

  • Jamie Hong Im Teoh Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia https://orcid.org/0000-0002-7522-4784
  • Norlaila Mustafa Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia https://orcid.org/0000-0002-0196-7091
  • Norasyikin Wahab Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

DOI:

https://doi.org/10.15605/jafes.038.01.19

Keywords:

Thyroid eye disease, SARS-CoV-2 vaccine, Radioactive iodine therapy, autoimmune/inflammatory syndrome induced by adjuvants, molecular mimicry

Abstract

Autoimmunity associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been well-described as the mechanism of development of thyroid dysfunction following Coronavirus Disease 19 (COVID-19) infection and SARS-CoV-2 vaccination. However, the occurrence of thyroid eye disease (TED) after SARS-CoV-2 vaccination is scarcely described. The postulated mechanisms include immune reactivation, molecular mimicry and the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). We report a case of new-onset TED after receiving the SARSCoV-
2 vaccine.

Downloads

Download data is not yet available.

Author Biographies

Jamie Hong Im Teoh, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

General Physician, Endocrine Unit, Department of Medicine

Norlaila Mustafa, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

Professor of Internal Medicine, Senior Consultant Physician and Endocrinologist, Endocrine Unit, Department of Medicine

Norasyikin Wahab, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia

Associate Professor of Internal Medicine and Consultant Endocrinologist, Endocrine Unit, Department of Medicine

References

World Health Organization. WHO coronavirus disease (COVID-19) dashboard. World Health Organization; 2022. https://covid19.who.int. Accessed December 13, 2022.

Murugan AK, Alzahrani AS. SARS-CoV-2 plays a pivotal role in inducing hyperthyroidism of Graves’ disease. Endocrine. 2021;73(2):243-54. https://pubmed.ncbi.nlm.nih.gov/34106438. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188762. https://doi.org/10.1007/s12020-021-02770-6.

Vera‑Lastra O, Ordinola Navarro A, Cruz Domiguez MP, Medina G, Sánchez Valadez TI, Jara LJ. Two cases of Graves’ disease following SARS‑CoV‑2 vaccination: An autoimmune/ inflammatory syndrome induced by adjuvants. Thyroid. 2021;31(9):1436‑9. https://pubmed.ncbi.nlm.nih.gov/33858208. https://doi.org/10.1089/thy.2021.0142.

İremli BG, Şendur SN, Ünlütürk U. Three cases of subacute thyroiditis following SARS‑CoV‑2 vaccine: Postvaccination ASIA syndrome. J Clin Endocrinol Metab. 2021;106(9):2600‑5. https://pubmed.ncbi.nlm.nih.gov/34043800. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8194612. https://doi.org/10.1210/clinem/dgab373.

Patel KR, Cunnane ME, Deschler DG. SARS‑CoV‑2 vaccine‑induced subacute thyroiditis. Am J Otolaryngol. 2021;43(1):103211. https://pubmed.ncbi.nlm.nih.gov/34534760. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426324. https://doi.org/10.1016/j.amjoto.2021.103211.

Soltanpoor P, Norouzi G. Subacute thyroiditis following COVID‑19 vaccination. Clin Case Rep. 2021;9(10):e04812. https://pubmed.ncbi.nlm.nih.gov/34631062. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8489499. https://doi/.org/10.1002/ccr3.4812.

Lui DTW, Lee KK, Lee CH, Hung IFN, Tan KCB. Development of Graves’ Disease after SARS-CoV-2 mRNA vaccination: A case report and literature review. Front Public Health. 2021;9:778964. https://pubmed.ncbi.nlm.nih.gov/34888290. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650637. https://doi.org/10.3389/fpubh.2021.778964.

Chua MWJ. Graves’ disease after COVID-19 vaccination. Ann Acad Med Singap. 2022;51(2):127-8. https://pubmed.ncbi.nlm.nih.gov/35224612. https://doi.org/10.47102/annals-acadmedsg.2021398.

Hamouche W, El Soufi Y, Alzaraq A, Okafor BV, Zhang F, Paras C. A case report of new onset graves’ disease induced by SARS-CoV-2 infection or vaccine? J Clin Transl Endocrinol Case Rep. 2022;23:100104. https://pubmed.ncbi.nlm.nih.gov/34934633. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8679515. https://doi.org/10.1016/j.jecr.2021.100104.

Bostan H, Ucan B, Kizilgul M, et al. Relapsed and newly diagnosed Graves’ disease due to immunization against COVID-19: A case series and review of the literature. J Autoimmun. 2022; 128:102809. https://pubmed.ncbi.nlm.nih.gov/35220164. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8867370. https://doi.org/10.1016/j.jaut.2022.102809.

Jafarzadeh A, Nemati M, Jafarzadeh S, Nozari P, Mortazavi SMJ. Thyroid dysfunction following vaccination with COVID-19 vaccines: A basic review of the preliminary evidence. J Endocrinol Invest. 2022;45(10):1835-63. https://pubmed.ncbi.nlm.nih.gov/35347651. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8960081. https://doi.org/10.1007/s40618-022-01786-7.

Bartalena L, Kahaly GJ, Baldeschi L, et al. The 2021 European Group on Graves’ orbitopathy (EUGOGO) clinical practice guidelines for the medical management of Graves’ orbitopathy. Eur J Endocrinol. 2021;185(4):G43–67. https://pubmed.ncbi.nlm.nih.gov/34297684. https://doi.org/10.1530/EJE-21-0479.

Lui DTW, Lee CH, Chow WS, et al. Thyroid dysfunction in relation to immune profile, disease status and outcome in 191 patients with COVID-19. J Clin Endocrinol Metab. 2021;106(2):e926-35. https://pubmed.ncbi.nlm.nih.gov/33141191. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665541. https://doi.org/10.1210/clinem/dgaa813.

Chin YH, Ng CH, Lee MH. Prevalence of thyroid eye disease in Graves’ disease: A meta‐analysis and systematic review. Clin Endocrinol (Oxf). 2020;93(4):363-74. https://pubmed.ncbi.nlm.nih.gov/32691849. https://doi.org/10.1111/cen.14296.

Rubinstein TJ. Thyroid Eye Disease Following COVID-19 vaccine in a patient with a history Graves’ disease: A case report. Ophthalmic Plast Reconstr Surg. 2021;37(6): e221-3. https://pubmed.ncbi.nlm.nih.gov/34570048. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8565453. https://doi.org/10.1097/IOP.0000000000002059.

Park KS, Fung SE, Ting M, et al. Thyroid eye disease reactivation associated with COVID‑19 vaccination. Taiwan J Ophthalmol. 2022;12(1):93‑6. https://pubmed.ncbi.nlm.nih.gov/35399967. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8988971. https://doi.org/10.4103/tjo.tjo_61_21.

Patrizio A, Ferrari SM, Antonelli A, Fallahi P. Worsening of Graves’ ophthalmopathy after SARS-CoV-2 mRNA vaccination. Autoimmun Rev. 2022; 21(7):103096. https://pubmed.ncbi.nlm.nih.gov/35413468. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8994413. https://doi.org/10.1016/j.autrev.2022.103096.

Cheng OT, Schlachter DM. Teprotumumab in advanced reactivated thyroid eye disease. Am. J. Ophthalmol Case Rep. 2022;26:101484. https://pubmed.ncbi.nlm.nih.gov/35321251. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935537. https://doi.org/10.1016/j.ajoc.2022.101484.

Mohamed A, Tzoulis P, Kossler AL, Dosiou C. New onset or deterioration of thyroid eye disease after mRNA SARS-CoV-2 vaccines: Report of 2 cases and literature review. J Clin Endocrinol Metab. 2022:dgac606. https://pubmed.ncbi.nlm.nih.gov/36251747. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9619817. https://doi.org/10.1210/clinem/dgac606.

Abeillon-du Payrat J, Grunenwald S, Gall E, Ladsous M, Raingeard I, Caron P. Graves' orbitopathy post-SARS-CoV-2 vaccines: Report on six patients. J Endocrinol Invest. 2022:1-11. https://pubmed.ncbi.nlm.nih.gov/36378488. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9665034. https://doi.org/10.1007/s40618-022-01955-8.

Jalkanen P, Kolehmainen P, Häkkinen HK. COVID-19 mRNA vaccine induced antibody responses against three SARS-CoV-2 variants. Nat Commun. 2021;12(1):3991. https://pubmed.ncbi.nlm.nih.gov/34183681. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8239026. https://doi.org/10.1038/s41467-021-24285-4.

Vojdani A, Vojdani E, Kharrazian D. Reaction of human monoclonal antibodies to SARS-CoV-2 proteins with tissue antigens: Implications for autoimmune diseases. Front Immunol. 2021;11:617089. https://pubmed.ncbi.nlm.nih.gov/33584709. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7873987. https://doi.org/10.3389/fimmu.2020.617089.

McLachlan SM, Nagayama Y, Pichurin PN, et al. The link between Graves’ disease and Hashimoto’s thyroiditis: A role for regulatory T cells. Endocrinology. 2007;148(12):5724-33. https://pubmed.ncbi.nlm.nih.gov/17823263. https://doi.org/10.1210/en.2007-1024.

Fröhlich E, Wahl R. Thyroid autoimmunity: Role of anti-thyroid antibodies in thyroid and extra-thyroidal diseases. Front Immunol. 2017;8:521. https://pubmed.ncbi.nlm.nih.gov/28536577. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5422478. https://doi.org/10.3389/fimmu.2017.00521.

Watad A, David P, Brown S, Shoenfeld Y. Autoimmune/inflammatory syndrome induced by adjuvants and thyroid autoimmunity. Front Endocrinol. 2017;7:150. https://pubmed.ncbi.nlm.nih.gov/28167927. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256113. https://doi.org/10.3389/fendo.2016.00150.

Taylor PN, Zhang L, Lee RWJ, et al. New insights into the pathogenesis and nonsurgical management of Graves orbitopathy. Nat Rev Endocrinol. 2020;16(2):104-16. https://pubmed.ncbi.nlm.nih.gov/31889140. https://doi.org/10.1038/s41574-019-0305-4.

Sriwijitalai W, Wiwanitkit V. Re: “Thyroid eye disease following COVID-19 vaccine in a patient with a history Graves’ disease: A case report.” Ophthalmic Plast Reconstr Surg. 2022;38(1):95. https://pubmed.ncbi.nlm.nih.gov/34982065. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8718104. https://doi.org/10.1097/IOP.0000000000002125.

Träisk F, Tallstedt L, Abraham-Nording M, et al. Thyroid-associated ophthalmopathy after treatment for Graves’ hyperthyroidism with antithyroid drugs or iodine-131. J Clin Endocrinol Metab. 2009;94(10):3700–7. https://pubmed.ncbi.nlm.nih.gov/19723755. https://doi.org/10.1210/jc.2009-0747.

Kung AWC, Yau CC, Cheng A. The incidence of ophthalmopathy after radioiodine therapy for Graves’ disease: Prognostic factors and the role of methimazole. J Clin Endocrinol Metab. 1994; 79(2):542-6. https://pubmed.ncbi.nlm.nih.gov/7913934. https://doi.org/10.1210/jcem.79.2.7913934.

Published

2023-02-08

How to Cite

Teoh, J. H. I., Mustafa, N., & Wahab, N. . (2023). New-onset Thyroid Eye Disease after COVID-19 Vaccination in a Radioactive Iodine-Treated Graves’ Disease Patient: A Case Report and Literature Review. Journal of the ASEAN Federation of Endocrine Societies, 38(1), 125–130. https://doi.org/10.15605/jafes.038.01.19

Issue

Section

Case Reports

Most read articles by the same author(s)