Subacute thyroiditis after vaccination

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 Subacute thyroiditis (= inflammatory thyroid disease characterised by neck pain, fever and thyroid dysfunction) after #COVIDVaccination:

https://casereports.bmj.com/content/14/10/e244711.long

"Clinicians should be aware of thyroid symptoms being potentially associated with the inactive SARS- CoV-2 vaccine."

Abstract

Viral infections have often been associated with subacute (De Quervain) thyroiditis. Rare cases of subacute thyroiditis have been reported after vaccines. Various vaccines have been developed with different techniques against SARS-CoV-2. This case report presents a rare case of subacute thyroiditis after the inactive SARS-CoV-2 virus vaccine, CoronaVac.


Case presentation

A 38-year-old female physician was admitted to the endocrinology outpatient clinic with reports of swelling in the neck, pain, fatigue, loss of appetite and sweating in the evening 2 weeks after being administered with the second dose of CoronaVac vaccine. The CoronaVac vaccine was administered on the first day and the 28th day. The patient stated that a slight pain and tenderness occurred in the thyroid lodge after the first dose, but it passed within a few days, and she did not consult a doctor during this period. The patient had no prior illness, previous vaccination or drug use. Physical examination revealed stage 2 goitre, and there was pain in the right thyroid lobe when it was touched. In laboratory tests, thyrotropin (TSH): 0.008 uIU/mL (normal: 0.27–4.2), free T3: 12.88 pg/mL (normal: 2–4), free T4: 4.65 ng/dL (normal: 0.93–1), anti-Tpo: 9.49 IU/mL (normal: 0–34), anti-Tg: 81.58 IU/mL (normal: 0–115), C reactive protein: 8.76 mg/L (normal: 0–0.8), sedimentation: 78 mm/hour (normal: 0–20) were detected. COVID-19 PCR testing was not performed as there were no COVID-related symptoms except SAT findings. Thyroid ultrasonography (USG) revealed an increased size of the right thyroid lobe, an irregularly demarcated hypoechoic area of approximately 3 cm in diameter compatible with thyroiditis starting from the capsule in the lateral and progressing into the lobe (white arrow in figure 1A). SAT diagnosis was established with a high acute phase, thyrotoxicosis and USG findings. Naproxen sodium 2×275 mg and propranolol 2×20 mg peroral treatment was initiated. Following treatment, the neck pain was alleviated. The patient stated that on the 14th day of the follow-up, her problems had mostly disappeared. The baseline and follow-up values of the patient are given in table 1.


CONTINUE HERE

https://casereports.bmj.com/content/14/10/e244711.long


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