Table 2.
Clinical characteristics, laboratory results and imaging findings of patients with SARS-CoV-2 vaccine-induced Graves’ disease
| N° | Author (Ref) | Gender | AGE | Type of vaccine | Dose | Time (days) | TSH | FT4 | TPO-Ab | Tg-Ab | TSHr-Ab | Thyroid ultrasound, Colour flow Doppler | Thyroid scintigraphy | Treatment | Follow-up |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Vera Lastra [24] | F | 40 | mRNA | 1st | 2 | <0.001 | 45.95 | Y | Y | Y | Enlarged thyroid gland, hypervascularity | NA | Propanolol, diltiazem, ivabradine, thiamazol | Good response |
| 2 | Vera Lastra [24] | F | 28 | mRNA | 1st | 3 | <0.001 | 23.68 | Y | N | Y | Diffuse toxic goiter | Propanolol, thiamazol | ||
| 3 | Zettinig [25] | F | 71 | mRNA | 2nd | 35 | 45.82 | Y | Multiple anechogenic areas, increased vascularisation | Patchy inhomogenous tracer distribution, midly increased uptake | Thyreostatic treatment | Normal thyroid function | |||
| 4 | Zettinig [25] | M | 46 | mRNA | 1st | 15 | 20.98 | Y | Slightly enlarged, hypo and anechogenic areas, increased vascularisation | Patchy inhomogenous tracer distribution, normal uptake | Thyreostatic treatment | Normal thyroid function | |||
| 5 | Lee [15] | F | 46 | Adenovirus vectored | 1st | 1 | 0.01 | 33.92 | Y | Y | Y | Increased vascularity | Increased uptake (38.6%) | ||
| 6 | Lee [15] | F | 73 | Adenovirus vectored | 2nd | 14 | <0.008 | 73.8 | Y | NA | Y | Increased vascularity | Increased uptake (54.2%) | ||
| 7 | Lee [15] | M | 34 | Adenovirus vectored | 1st | 14 | 26.61 | NA | NA | Y | Increased vascularity | ||||
| 8 | Lee [15] | M | 39 | Adenovirus vectored | 1st | 14 | <0.01 | 36.98 | NA | Y | Y | Diffuse goiter, ill-defined, hypoechoic lesion in left lobe | Increased uptake (13.8%) | ||
| 9 | Sriphrapradang [26] | M | 70 | Adenovirus vectored | 2nd | 2 | 0.003 | 41.06 | NA | NA | Y | Methimazole | |||
| 10 | Pujol [17] | F | 38 | mRNA | 1st | 12 | 0.008 | 25.87 | Y | Y | Y | Diffuse hypoechogenicity, increased vascularity | Hyperfunctionning diffuse goiter | Methimazole | |
| 11 | Goblirsch [27] | F | 71 | mRNA | 2nd | <0.01 | 92.68 | N | N | Y | Multinodular goiter | Methimazole | Euthyroidism at 1 month | ||
| 12 | Hamouche [28] | M | 32 | mRNA | 1st | 22 | <0.005 | 69.63 | Y | Y | Y | Heterogenous thyrous | Increased uptake (72%) | Methimazole, propanolol, prednisone (7 days) | Euthyroidism at 8 weeks |
| 13 | Lui [29] | F | 40 | mRNA | 2nd | 39 | <0.02 | 66.6 | Y | Y | Y | Heterogenous echogenicity, increased vascularity | Diffuse markedly increased uptake | Stop LT4, carbimazole, propanolol | Improvement of thyroid function |
| 14 | Patrizio [30] | M | 52 | mRNA | 2nd | 28 | <0.004 | 71.57 | Y | ± | Y | Enlarged thyroid, heterogenous echotexture, increased vascularisation | Methimazole, atenolol | Normalisation of thyroid hormones | |
| 15 | Sriphrapradang [31] | F | 30 | Adenovirus vectored | 3rd | 4 | 0.006 | 16.6 | Y | Methimazole | |||||
| 16 | Pierman [32] | F | 34 | mRNA | 1st | 10 | 0.01 | 32.69 | NA | NA | Y | Thiamazol | |||
| 17 | Yamamoto [33] | F | 64 | mRNA | 1st | 4 | <0.008 | 42.73 | NA | NA | Y | Goiter, increased vascularisation | Thiamazole, potassium iodine, corticosteroid, furosemide, carvedilol | Normalisation of thyroid hormones in 23 days | |
| 18 | Di Filippo [34] | M | 32 | Adenovirus vectored | 2nd | 10 | 0.005 | 38.1 | Y | Enlarged thyroid gland, pseudonodules, hypervascularisation | Propanolol, thiamazole then propylthiouracil (rush) | Euthyroidism in 3 months, decreased anti-TSHr antibodies | |||
| 19 | Di Filippo [34] | M | 35 | Adenovirus vectored | 1st | 5 | <0.004 | 63.84 | Y | Enlarged thyroid gland, hypervascularisation | Propanolol, thiamazol | Good clinical and hormonal response, normal antiTSHr antibodies at 3 months | |||
| 20 | Pla Peris [19] | F | 71 | mRNA | 2nd | 60 | <0.005 | 29.6 | Y | N | Y | Enlarged thyroid, increased vascularity | Diffuse markedly increased uptake | Methimazole | Decreased Ac anti-TSHr after 2 months |
| 21 | Pla Peris [19] | F | 42 | mRNA | 1st | <14 | <0.005 | 37.32 | N | NA | Y | Enlarged thyroid, increased vascularity | Diffuse markedly increased uptake | Methimazole | Decreased Ac anti-TSHr after 2 months |
| 22 | Pla Peris [19] | F | 54 | mRNA | 2nd | <14 | <0.005 | 60.5 | Y | Y | Y | Enlarged thyroid, increased vascularity | NA | Methimazole | |
| 23 | Pla Peris [19] | F | 46 | mRNA | 1st | 50 | <0.005 | 41.19 | Y | Y | y | Enlarged thyroid, increased vascularity | NA | Methimazole | |
| 24 | Pla Peris [19] | F | 69 | mRNA | 1st | <14 | <0.005 | 23.17 | N | N | Y | Enlarged thyroid gland, heterogeneous echogenicity, diffuse hypoechoic pattern | NA | Methimazole, non-steroidal antiinflammatory drugs | |
| 25 | Raven [21] | F | 35 | Adenovirus vectored | 1st | 5 | <0.02 | 64 | Y | Y | Y | Diffuse heterogeneous thyroid, marked increased vascularity | Carbimazole | ||
| 26 | Weintraub [35] | F | 38 | mRNA | 1st | 5 | <0.008 | 108 | Y | NA | Y | Diffusely enlarged gland, heterogeneous echogenicity, increased vascularity | Methimazole, propanolol | Normal FT4 at 3 months | |
| 27 | Weintraub [35] | F | 63 | mRNA | 2nd | 4 | 0.011 | 30.9 | Y | NA | Y | Heterogeneous hypervascular thyroid gland | At 6 months: high radiotracer activity in both lobes, uptake at 24 h: 41% | No treatment | |
| 28 | Weintraub [35] | M | 30 | mRNA | 2nd | 28 | <0.005 | 22.9 | N | N | Y | Methimazole, atenolol | At 6 weeks, normal FT4, improvement of irritability and restless sleep | ||
| 29 | Oguz [23] | F | 40 | mRNA | 1st | 2 | <0.015 | 27.92 | Y | Y | Y | Diffuse hyperplasia, increased vascularisation | Diffusely increase radiotracer uptake | Methimazole | Not in remission |
| 30 | Oguz [23] | M | 29 | mRNA | 1st | 15 | <0.015 | 12.15 | N | N | N | Diffuse hyperplasia, increased vascularisation | 24-h RAIU: 27% | No treatment | Remission 10 weeks |
| 31 | Oguz [23] | F | 43 | mRNA | 1st | 9 | 0.015 | 33.1 | N | N | N | Diffuse hyperplasia, increased vascularisation | 24-h RAIU: 61% | Methimazole | Not in remission |
| 32 | Oguz [23] | F | 43 | mRNA | 1st | 14 | 0.01 | 25.5 | Y | Y | Y | Diffuse hyperplasia, increased vascularisation | 24-h RAIU: 23% | Stop levothyroxine | Hypothyroidism at 20th week |
Age in years, Time in days, TSH in mU/L, and FT4 in pmol/l
Gender F female, M male, Y yes, N not present, TPO-Ab TPO antibody, Tg-Ab Tg antibody, TSHr-Ab TSH receptor antibody, NA not available