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Two further cases of Graves’ disease following SARS-Cov-2 vaccination

2021; Springer Science+Business Media; Volume: 45; Issue: 1 Linguagem: Inglês

10.1007/s40618-021-01650-0

1720-8386

Georg Zettinig, Michael Krebs,

interferon and immune responses

Recently, two cases of Graves' disease after SARS-Cov2 RNA vaccination with tozinameran have been reported [1].Here, we report two further cases: a late recurrence after 17 years and an initial manifestation.A 71-year-old lady had subtotal resection of the left lobe.Soon thereafter, Graves' disease occurred, treated by thyreostatic drugs until 2004.She has been in care of our Thyroid Center since 2008.She was euthyroid with normal TSH-receptor-antibody (TRAB) levels at yearly checkups.Sonography also did not show any dynamics: an enlarged 20 ml right lobe and a small 4 ml left lobe after partial resection.The parenchyma was slightly hypoechogenic.She was vaccinated with tozinameran on 21.March and 11.April.From Mid-May on, she noticed palpitations and sweating.On 26th May, she was seen in our Thyroid Center with a free T4 of 3.56 ng/dl (normal 0.70-1.70),a free T3 of 11.10 pg/ ml (normal 2.15-4.12),and a TRAB level of 4.2 IU/l (normal < 1.5).A marked change in sonography with multiple confluent anechogenic areas and increased vascularization was observed.Scintigraphy revealed the small (partly resected) left lobe and the enlarged right lobe with a patchy inhomogenous tracer distribution.Uptake was only mildly increased.Thyreostatic treatment led to a rapid normalization of thyroid function.