HLA typing of patients who developed subacute thyroiditis and Graves’ disease after SARS-CoV-2 vaccination: a case report

Table 1 Biochemical and thyroid function test data of patients who developed thyroid dysfunction after SARS-CoV-2 vaccination

		Days after the 1st SARS-CoV-2 vaccination^a
Patient 1	Reference range	Day 10	Day 16	Day 43	Day 92	Day 120	Day 148	Day 176
CRP, mg/dL	< 0.14	NA	7.19	< 0.1	< 0.1	< 0.1	< 0.1	< 0.1
TSH, μIU/mL	0.39–3.98	NA	< 0.01	12.84	3.69	3.78	3.68	3.57
FT3, pg/mL	2.15–4.24	NA	5.19	1.44	2.59	3.05	2.94	2.91
FT4, ng/mL	0.9–1.7	NA	2.43	0.59	0.92	0.95	0.99	1.10
TRAb, IU/L	< 1.9	NA	< 0.8	NA	1.0	1.0	< 0.8	0.8
TSAb, %	< 120.0	NA	122.0	NA	129.0	129.0	111.0	108.0
TgAb, IU/mL	< 27.0	NA	37.0	NA	NA	14.0	14.0	13.0
TPOAb, IU/mL	< 15.0	NA	252.0	NA	NA	72.0	35.0	12.0
Symptoms		Fever (38.0 °C) Cervical pain Palpitations Fatigue		Resolution of all symptoms
		Days after the 2nd SARS-CoV-2 vaccination^b
Patient 2	Reference range	Day 3	Day 28	Day 30	Day 51	Day 79	Day 87	Day 108	Day 138
CRP, mg/dL	< 0.14	NA	NA	4.48	0.22	0.12	0.14	0.12	< 0.1
TSH, μIU/mL	0.39–3.98	NA	< 0.01	< 0.01	< 0.01	0.56	< 0.01	< 0.01	1.65
FT3, pg/mL	2.15–4.24	NA	17.90	12.88	3.67	3.54	5.92	4.65	3.91
FT4, ng/mL	1.0–1.7	NA	5.13	4.18	1.54	1.32	1.67	1.64	1.58
TRAb, IU/L	< 1.9	NA	26.6	34.5	NA	34.5	NA	64.5	63.6
TSAb, %	< 120.0	NA	NA	1506.0	NA	269.0	NA	159.0	130.0
TgAb, IU/mL	< 27.0	NA	NA	38.0	NA	30.0	NA	96.0	62.0
TPOAb, IU/mL	< 15.0	NA	NA	77.0	NA	137.0	NA	220.0	174.0
Symptoms		Fever (37.8 °C) Pain in the left lobe of the thyroid gland	Fever (38.9 °C) Headache Pain in the left lobe of the thyroid gland Palpitations	Fever (37.5 °C) Pain in the right lobe of the thyroid gland Palpitations		Resolution of all symptoms	Fever (37.3 °C) Palpitations		Resolution of all symptoms
Imaging studies				TUS			TS
Medications			MMI 15 mg/day	Discontinuation of MMI administration PSL 20 mg/day		Discontinuation of PSL	MMI 10 mg/day		MMI 5 mg/day

^aInoculated vaccine (BNT162b2, Pfizer, New York, NY, USA)
^bInoculated vaccine (mRNA-1273; Moderna, Cambridge, MA, USA)
SARS-CoV-2 severe acute respiratory syndrome coronavirus 2, CRP C-reactive protein, NA not applicable, TSH thyroid-stimulating hormone, FT3 free triiodothyronine, FT4 free thyroxine, TRAb antithyroid-stimulating hormone receptor antibody, TSAb antithyroid-stimulating antibody, TgAb antithyroglobulin antibody, TPOAb antithyroid peroxidase antibody, TUS thyroid ultrasonography, TS thyroid scintigraphy with ^99mtechnetium pertechnetate, MMI thiamazole, PSL prednisolone

ISSN: 1472-6823