Asia Oceania Journal of Nuclear Medicine and Biology

Asia Oceania Journal of Nuclear Medicine and Biology

Graves’ disease post-COVID-19 m-RNA vaccine in pediatric age group

Document Type : Case report

Authors
Abhaa Sulaiyam Al-Jahhafi 1
Asma Ali Al-Sawaai 1
Zamzam Khalifa Al-Bimani 2
Naima Khamis Al bulushi 2
1 Oman Medical Specialty Board (OMSB), radiology residency Program, Oman
2 Nuclear Medicine Department and Molecular Imaging Centre, Royal Hospital, Oman
10.22038/aojnmb.2023.73051.1510
Abstract
The surge of the COVID-19 pandemic (December / 2019 - May/2023) and its catastrophic effect worldwide have necessitated emergent intervention to reduce its influence on people's health and life. To eliminate and reduce the impact of COVID-19 infection, COVID-19 vaccination was emergently authorized in December 2020 which has established good safety and efficacy. Having said that, some adverse effects merged in a few individuals. We are reporting an adolescent patient a 17-year-old female who has been diagnosed with Graves’ disease after post-COVID-19 vaccinations. In addition, she was a confirmed case of COVID-19 infection three months earlier. The patient presented with typical features of hyperthyroidism 30 days post receiving the first dose of the vaccination. Based on the patient's presentation relative to the administration of the vaccine and prior infection of the virus. We proposed the synergistic effect of both factors to induce Graves’ disease in this young healthy female with no family history of autoimmune disease. We are reporting this case for pediatric endocrinologists to be aware of the interaction and possible impact of the COVID-19 vaccine on thyroid function.
Keywords
Thyroiditis
COVID-19 Vaccine
Graves' Disease
Subjects
  1. Lee HS, Hwang JS. The treatment of Graves’ disease in children and adolescents. Annals of Pediatric Endocrinology & amp; Metabolism. 2014; 19(3):122.
  2. Donner JR, Has P, Topor LS. Increased incidence and severity of new Graves’ disease diagnoses in youth during the COVID-19 pandemic. Endocr Pract. 2023; 29(5):349-352.
  3. Livingston EH, Malani PN, Creech CB. The Johnson & Johnson vaccine for covid-19. JAMA. 2021; 325(15):1575.
  4. Mulligan MJ, Lyke KE, Kitchin N, Absalon J, Gurtman A, Lockhart S, et al. Phase I/II study of COVID-19 RNA vaccine BNT162b1 in adults. Nature .2020; 586:589-593.
  5. Barrett JR, Belij-Rammerstorfer S, Dold C, Ewer KJ, Folegatti PM, Gilbride C, et al. Phase 1/2 trial of SARS-CoV-2 vaccine ChAdOx1 nCoV-19 with a booster dose induces multifunctional antibody responses. Nat Med .2021; 27(2):279–88.
  6. Zheng C, Shao W, Chen X, Zhang B, Wang G, Zhang W. Real-world effectiveness of COVID-19 vaccines: A literature review and meta-analysis. Int. J. Infect. 2021; 114: 252–260.
  7. Gao P, Liu J, Liu M. Effect of covid-19 vaccines on reducing the risk of long COVID in the real world: A systematic review and meta-analysis. International Journal of Environmental Research and Public Health. 2022; 19(19):12422.
  8. Chimatapu SN, Ferber CJ, Thambundit A, Okawa ER. Two cases of thyroiditis in adolescents following COVID-19 vaccinations. JCEM Case Reports. 2023; 1 (2):luad017.
  9. Triantafyllidis KK, Giannos P, Stathi D, Kechagias KS. Graves‘disease following vaccination against SARS-CoV-2: A systematic review of the reported cases. Frontiers in Endocrinology. 2022; 13: 938001.
  10. Hamouche W, El Soufi Y, Alzaraq S, Okafor BV, Zhang F, Paras C. A case report of new onset Graves’ disease induced by SARS-CoV-2 infection or vaccine? Journal of Clinical and Translational Endocrinology: Case Reports. 2022; 23:100104.
  11. Shi S, Liang Z, Sun B. Response to comment on: Vaccine adjuvants: Understanding the structure and mechanism of adjuvant city. Vaccine. 2020; 38(13):2759.
  12. Herczeg V, Garai R, Takács J, et al. Thyroid disturbances after COVID-19 and the effect of vaccination in children: a prospective tri-center registry analysis. Eur J Pediatr. 2023; 182(10):4443-4455.
  13. Prummel MF, Strieder T, Wiersinga WM. The environment and autoimmune thyroid diseases. Eur. J. Endocrinol.2004; 150(5): 605–618.
  14. Costela-Ruiz VJ. Illescas-Montes R, Puerta-Puerta JM, Ruiz C, Melguizo-Rodríguez L. SARS-CoV-2 infection: the role of cytokines in COVID-19 disease. Cytokine Growth Factor Rev.2020; 54: 62–75.
  15. El Sabbagh R, Azar NS, Eid AA, Azar ST.Thyroid dysfunctions due to immune checkpoint inhibitors: a review. Int J. Gen. Med.2020; 13: 1003–1009.
  16. Bragazzi NL, Hejly A, Watad A, Adawi M, Amital H, Shoenfeld Y. ASIAsyndrome and endocrine autoimmune disorders. Best Practice & amp; Research Clinical Endo-crinology & amp; Metabolism. 2020; 34(1): 101412.
  17. Sharma A, Stan MN. Thyrotoxicosis: Diagnosis and Management. Mayo Clinic Proceedings. 2019; 94(6):1048–64.
  18. Žarković M. The role of oxidative stress on the pathogenesis of Graves‘disease. Journal of Thyroid Research. J Thyroid Res. 2012; 2012: 302537.
  19. Smith TJ. Pathogenesis of Graves’ orbitopathy: a 2010 update. Journal of endo-crinological investigation. 2010; 33: 414-21.
Asia Oceania Journal of Nuclear Medicine and Biology
Volume 12, Issue 1
January 2024
Pages 65-68