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Worsening of Graves' ophthalmopathy after SARS-CoV-2 mRNA vaccination

Armando Patrizio1, Silvia Martina Ferrari2, Alessandro Antonelli3

  • 1Department of Emergency Medicine, Azienda Ospedaliero-Universitaria Pisana, Italy.

Autoimmunity Reviews
|April 12, 2022
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines may trigger autoimmune endocrine diseases in predisposed individuals. Two cases of Graves' ophthalmopathy recrudescence were reported following the Pfizer-BioNTech SARS-CoV-2 vaccine.

Area of Science:

  • Endocrinology
  • Immunology
  • Vaccinology

Background:

  • Growing evidence suggests vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may act as external triggers for autoimmune endocrine diseases (AIED) in susceptible individuals.
  • Autoimmune endocrine diseases are conditions where the immune system mistakenly attacks endocrine glands.

Observation:

  • Two cases of Graves' ophthalmopathy (GO) recrudescence are presented.
  • These events occurred within days following administration of the BNT162b2 (Pfizer-BioNTech) SARS-CoV-2 vaccine.

Findings:

  • While a definitive causal relationship is not established, the recrudescence of GO suggests a potential link.
  • Immune-mediated mechanisms, such as autoimmune/inflammatory syndrome induced by adjuvants (ASIA), may explain these occurrences.

Implications:

  • Further research is needed to elucidate the precise pathogenesis of vaccine-associated AIED.
  • Caution is advised when administering SARS-CoV-2 vaccines to patients with pre-existing autoimmune conditions.
Keywords:
COVID-19Graves' diseaseGraves' ophthalmopathySARS-CoV-2Vaccine

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