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A Case of Hypophysitis Following Immunization With the mRNA-1273 SARS-CoV-2 Vaccine
Natia Murvelashvili1, Alex Tessnow1
1The University of Texas Southwestern Medical Center, Dallas, USA.
Abstract:
The emergence of a novel coronavirus and global pandemic raised the need for the rapid development of new vaccines to reduce the morbidity and mortality associated with Covid-19. Common side effects of these vaccines such as myalgia, arthralgia, nausea, fatigue, and injection site reaction are usually self-resolving. Recognition of other potential adverse effects of these novel vaccines is important due to their rapid and widespread distribution. We report a case of a 51-year-old man admitted to Parkland Memorial Hospital with headache, nausea, vomiting, malaise, and diffuse arthralgias 3 days after he received his second mRNA-1273 SARS-CoV-2 vaccination. He was found to have hyponatremia and a low serum cortisol level. Further workup revealed hypopituitarism with central hypothyroidism, hypogonadism, and a subnormal response to cosyntropin. Magnetic resonance imaging revealed a diffusely enlarged pituitary gland consistent with acute hypophysitis. The patient responded well to glucocorticoid and thyroid hormone supplementation and was discharged after 2 days in the hospital. This is the first reported case of hypopituitarism potentially associated with Covid-19 immunization.
Insights
A case study reports hypopituitarism, a rare adverse effect, following the second mRNA-1273 SARS-CoV-2 vaccination. This condition, characterized by pituitary gland inflammation, resolved with hormone replacement therapy.
Area of Science:
- Endocrinology
- Immunology
- Vaccinology
Background:
- The COVID-19 pandemic necessitated rapid vaccine development, leading to widespread mRNA-1273 SARS-CoV-2 immunization.
- While common side effects are typically mild and self-resolving, vigilance for rarer adverse events is crucial given the vaccine's global distribution.
Observation:
- A 51-year-old male presented with headache, nausea, vomiting, malaise, and arthralgias three days post-second mRNA-1273 vaccination.
- Initial workup revealed hyponatremia, low serum cortisol, and evidence of hypopituitarism, including central hypothyroidism and hypogonadism.
Findings:
- Further investigation confirmed hypopituitarism with a subnormal response to cosyntropin stimulation.
- Magnetic resonance imaging demonstrated a diffusely enlarged pituitary gland, indicative of acute hypophysitis.
- This represents the first reported instance of hypopituitarism potentially linked to COVID-19 vaccination.
Implications:
- The patient's successful response to glucocorticoid and thyroid hormone supplementation highlights the importance of prompt diagnosis and management.
- This case underscores the need for continued monitoring and research into potential rare neurological and endocrine adverse effects of novel vaccines.
