Table 2.
Case reports of thyroid dysfunction after SARS-CoV-2 vaccination.
| Sex/Age | Country | Type of vaccine | Past health and family history | Time of onset after vaccination | TFT at diagnosis | Thyroid Ab | Thyroid ultrasonography | Technetium thyroid scan | References |
|---|---|---|---|---|---|---|---|---|---|
| Graves' disease | |||||||||
| F/40 | Mexico | mRNA | PH: hypertension, COVID-19 FH: N/A |
2 days later | TSH <0.001 mIU/L (N: 0.27–4.4) fT4 3.57 ng/dL (N: 0.93–1.71) fT3 10.5 pg/mL (N: 2.04–4.4) |
Anti-TPO +ve Anti-Tg +ve TRAB +ve TSI +ve |
Enlargement and hypervascularity | N/A | (8) |
| F/28 | Mexico | mRNA | PH: good FH: N/A |
3 days later | TSH <0.001 mIU/L (N: 0.27–4.4) fT4 1.84 ng/dL (N: 0.93–1.71) fT3 9.2 pg/mL (N: 2.04–4.4) |
Anti-TPO +ve Anti-Tg -ve TRAB +ve |
N/A | Diffuse toxic goiter | (8) |
| F/71 | Austria | mRNA | PH: Graves' disease FH: N/A |
56 d after 1st dose 35 d after 2nd dose |
fT4 3.56 ng/dL (N: 0.70–1.70) fT3 11.10 pg/mL (N: 2.15–4.12) |
TRAB +ve | Multiple confluent anechogenic areas and increased vascularization | Small (partly resected) left lobe and the enlarged right lobe with a patchy inhomogeneous tracer distribution; mildly increased uptake | (9) |
| M/46 | Austria | mRNA | PH: good FH: N/A |
15 d after 1st dose | fT4 1.63 ng/dL (N: 0.70–1.70) fT3 5.18 pg/mL (N: 2.15–4.12) |
TRAB +ve | Slightly enlarged thyroid; In the hypoechogenic parenchyma, large anechogenic areas with increased vascularization | Patchy, very inhomogeneous Tc99m accumulation; normal uptake | (9) |
| Subacute thyroiditis | |||||||||
| F/57 | United States | mRNA | PH: good FH: N/A |
35 d after 1st dose 13 d after 2nd dose |
TSH <0.008 mIU/L (N: 0.4–4.2) fT4 1.92 ng/dL (N: 0.8–1.5) TT3 137 ng/dL (N: 87–178) | Anti-TPO -ve Anti-Tg -ve TSI -ve |
Asymmetrically enlarged hypervascular heterogeneous right thyroid lobe | N/A | (2) |
| F/49 | Germany | mRNA | PH: good FH: father had benign thyroid nodules |
14 d after 1st dose | TSH 0.5 mIU/L (N: 0.35–4.94) fT4 9.4 ng/L (N: 7.0–14.8) fT3 3.25 ng/L (N: 1.71–3.71) |
Anti-TPO -ve Anti-Tg -ve TRAB -ve |
Distinct ill-defined hypoechoic area with decreased blood flow | N/A | (3) |
| F/35 | Turkey | Inactivated | PH: good FH: nil |
32 d after 1st dose 4 d after 2nd dose |
TSH 0.473 mIU/L (N: 0.38–5.33) fT4 14.1 pmol/L (N: 7.86–14.41) fT3 6.15 pmol/L (N: 3.8–6.0) |
Anti-TPO -ve Anti-Tg -ve TRAB -ve |
Bilateral focal hypoechoic areas with decreased blood flow | N/A | (4) |
| F/34 | Turkey | Inactivated | PH: mild COVID-19 FH: nil |
4 d after 1st dose | TSH 0.01 mIU/L (N: 0.38–5.33) fT4 11.8 pmol/L (N: 7.86–14.41) fT3 5.2 pmol/L (N: 3.8–6.0) |
Anti-TPO -ve Anti-Tg -ve TRAB -ve |
Bilateral focal hypoechoic areas with decreased blood flow | N/A | (4) |
| F/37 | Turkey | Inactivated | PH: good FH: nil |
7 d after 2nd dose | TSH 0.9 mIU/L (N: 0.38–5.33) fT4 13.85 pmol/L (N: 7.86–14.41) fT3 6.05 pmol/L (N: 3.8–6.0) |
Anti-TPO -ve Anti-Tg -ve TRAB -ve |
Bilateral hypoechoic areas with irregular borders and reduced blood flow | N/A | (4) |
| M/67 | Turkey | Inactivated | PH: controlled hypertension FH: N/A |
48 d after 1st dose 20 d after 2nd dose |
TSH 0.005 mIU/L (N: 0.27–4.2) fT4 2.87 ng/dL (N: 0.93–1.7) fT3 8.06 pg/mL (N: 2.7–4.3) |
Anti-TPO -ve Anti-Tg -ve TRAB -ve |
Reduced echogenicity and diffusely heterogeneous texture with pseudonodular areas | N/A | (5) |
| F/32 | Brazil | Inactivated | PH: good FH: N/A |
12 h after 2nd dose | TSH 13.2 mIU/L (N: 0.45–4.5) T4 normal |
Anti-TPO +ve Anti-Tg +ve |
N/A | N/A | (6) |
| F/26 | Germany | Inactivated | PH: good FH: nil |
14 d after 1st dose | TSH 1.75 mIU/L (N: 0.35–4.94) fT4 9.3 ng/L (N: 7.0–14.8) fT3 3.72 ng/L (N: 1.71–3.71) |
Anti-TPO -ve Anti-Tg -ve TRAB -ve |
Distinct ill-defined hypoechoic areas with decreased blood flow | N/A | (3) |
| F/55 | United Kingdom | Adenovirus-vectored | PH: controlled asthma FH: nil |
21 d after 1st dose | TSH 0.09 mIU/L (N: 0.3–4.2) fT4 25.2 pmol/L (N: 12.0–22.0) |
Anti-TPO -ve | Enlarged thyroid gland with heterogeneous echotexture throughout; no nodules or hypervascularity | N/A | (7) |
F, female; M, male; d, days; PH, past health; FH, family history; TSH, thyroid-stimulating hormone; fT4, free thyroxine; fT3, free triiodothyronine; anti-TPO, anti-thyroid peroxidase; anti-Tg, anti-thyroglobulin; TRAB, TSH receptor antibody; TSI, thyroid stimulating immunoglobulin; N/A, not available; Ab, antibody; TFT, thyroid function test.