Subacute Thyroiditis Developing Within 2 Days of Vaccination Against COVID-19 with BNT162b2 mRNA
  • Kenya Ie
    Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Division of General Internal Medicine, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Kanagawa, Japan
  • Kosuke Ishizuka
    Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan
  • Tsubasa Sakai
    Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Division of General Internal Medicine, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Kanagawa, Japan
  • Iori Motohashi
    Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan; Division of General Internal Medicine, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Kanagawa, Japan
  • Shiko Asai
    Division of Metabolism and Endocrinology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Kanagawa, Japan
  • Chiaki Okuse
    Division of General Internal Medicine, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki-city, Japan; Division of General Internal Medicine, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, Kawasaki, Kanagawa, Japan

Keywords

Subacute thyroiditis, COVID-19 vaccination, COVID-19, vaccination

Abstract

A 32-year-old woman presented to the outpatient clinic with persistent fever, anterior neck pain, and palpitations over the past week which developed 2 days after she had received the first dose of the Pfizer/BioNTech SARS-CoV-2 mRNA vaccine. On examination, the patient’s heart rate was 140 beats per minute and the thyroid gland was tender on palpation. Laboratory studies showed a low serum TSH level with elevated free thyroxine. Thyroid ultrasound revealed low-echoic lesions compatible with the site of tenderness. The patient was diagnosed with subacute thyroiditis and treatment was initiated with acetaminophen and propranolol, which resulted in symptom resolution within 2 weeks. Clinicians should be aware that subacute thyroiditis may occur within a few days following COVID-19 vaccination, especially in patients with anterior cervical pain with no significant abnormal pharyngeal findings and/or severe palpitations, because differentiating them from early non-specific adverse reactions can be challenging.

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References

  • Siolos A, Gartzonika K, Tigas S. Thyroiditis following vaccination against COVID-19: report of two cases and review of the literature. Metabol Open 2021;12:100136.
  • Sozen M, Topaloglu O, Cetinarslan B, Selek A, Canturk Z, Gezer E, et al. COVID-19 mRNA vaccine may trigger subacute thyroiditis. Hum Vaccin Immunother 2021;17(12):5120–5125.
  • Pla Peris B, Merchante Alfaro AÁ, Maravall Royo FJ, Abellán Galiana P, Pérez Naranjo S, González Boillos M. Thyrotoxicosis following SARS-COV-2 vaccination: a case series and discussion. J Endocrinol Invest 2022;45(5):1071–1077.
  • Iremli BG, Sendur SN, Unluturk U. Three cases of subacute thyroiditis following SARS-CoV-2 vaccine: postvaccination ASIA syndrome. J Clin Endocrinol Metab 2021;106:2600–2605.
  • Chung YH, Beiss V, Fiering SN, Steinmetz NF. COVID-19 vaccine frontrunners and their nanotechnology design. ACS Nano 2020;14:12522–12537.
  • Verbeke R, Lentacker I, De Smedt SC, Dewitte H. Three decades of messenger RNA vaccine development. Nano Today 2019;28:100766.
  • Chatzi S, Karampela A, Spiliopoulou C, Boutzios G. Subacute thyroiditis after SARS-CoV-2 vaccination: a report of two sisters and summary of the literature. Hormones (Athens) 2022;21:177–179.

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    Published: 2023-02-03
    Issue: 2023: Vol 10 No 1 (view)

    How to cite:
    1.
    Ie K, Ishizuka K, Sakai T, Motohashi I, Asai S, Okuse C. Subacute Thyroiditis Developing Within 2 Days of Vaccination Against COVID-19 with BNT162b2 mRNA. EJCRIM 2023;10 doi:10.12890/2022_003735.