PMID- 36879263
OWN - NLM
STAT- MEDLINE
DCOM- 20230314
LR  - 20230314
IS  - 1472-6823 (Electronic)
IS  - 1472-6823 (Linking)
VI  - 23
IP  - 1
DP  - 2023 Mar 7
TI  - HLA typing of patients who developed subacute thyroiditis and Graves' disease 
      after SARS-CoV-2 vaccination: a case report.
PG  - 54
LID - 10.1186/s12902-023-01287-5 [doi]
LID - 54
AB  - BACKGROUND: Cases of subacute thyroiditis (SAT) after severe acute respiratory 
      syndrome coronavirus 2 (SARS-CoV-2) vaccination have been reported. A human 
      leukocyte antigen (HLA) allele, HLA-B*35, appears to be involved in the 
      pathogenesis of SAT. CASE PRESENTATION: We conducted HLA typing of one patient 
      with SAT and another with both SAT and Graves' disease (GD), which developed 
      after SARS-CoV-2 vaccination. Patient 1, a 58-year-old Japanese man, was 
      inoculated with a SARS-CoV-2 vaccine (BNT162b2; Pfizer, New York, NY, USA). He 
      developed fever (38  degrees C), cervical pain, palpitations, and fatigue on day 10 after 
      vaccination. Blood chemistry tests revealed thyrotoxicosis and elevated serum 
      C-reactive protein (CRP) and slightly increased serum antithyroid-stimulating 
      antibody (TSAb) levels. Thyroid ultrasonography revealed the characteristic 
      findings of SAT. Patient 2, a 36-year-old Japanese woman, was inoculated twice 
      with a SARS-CoV-2 vaccine (mRNA-1273; Moderna, Cambridge, MA, USA). She developed 
      fever (37.8  degrees C) and thyroid gland pain on day 3 after the second vaccination. 
      Blood chemistry tests revealed thyrotoxicosis and elevated serum CRP, TSAb, and 
      antithyroid-stimulating hormone receptor antibody levels. Fever and thyroid gland 
      pain persisted. Thyroid ultrasonography revealed the characteristic findings of 
      SAT (i.e., slight swelling and a focal hypoechoic area with decreased blood 
      flow). Prednisolone treatment was effective for SAT. However, thyrotoxicosis 
      causing palpitations relapsed thereafter, for which thyroid scintigraphy with 
      (99m)technetium pertechnetate was conducted, and the patient was diagnosed with 
      GD. Thiamazole treatment was then initiated, which led to improvement in 
      symptoms. CONCLUSION: HLA typing revealed that both patients had the HLA-B*35:01, 
      -C*04:01, and -DPB1*05:01 alleles. Only patient 2 had the HLA-DRB1*11:01 and 
      HLA-DQB1*03:01 alleles. The HLA-B*35:01 and HLA-C*04:01 alleles appeared to be 
      involved in the pathogenesis of SAT after SARS-CoV-2 vaccination, and the 
      HLA-DRB1*11:01 and HLA-DQB1*03:01 alleles were speculated to be involved in the 
      postvaccination pathogenesis of GD.
CI  - (c) 2023. The Author(s).
FAU - Yasuda, Shigemitsu
AU  - Yasuda S
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan. shigemitsuyasuda@msn.com.
FAU - Suzuki, Seiya
AU  - Suzuki S
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
FAU - Yanagisawa, Shinnosuke
AU  - Yanagisawa S
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
FAU - Morita, Hideo
AU  - Morita H
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
FAU - Haisa, Akifumi
AU  - Haisa A
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
FAU - Satomura, Atsushi
AU  - Satomura A
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
FAU - Nakajima, Ritsuko
AU  - Nakajima R
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
FAU - Oikawa, Yoichi
AU  - Oikawa Y
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
FAU - Inoue, Ikuo
AU  - Inoue I
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
FAU - Shimada, Akira
AU  - Shimada A
AD  - Department of Endocrinology and Diabetes, Saitama Medical University, Morohongo 
      38, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20230307
PL  - England
TA  - BMC Endocr Disord
JT  - BMC endocrine disorders
JID - 101088676
RN  - 0 (BNT162 Vaccine)
RN  - 0 (COVID-19 Vaccines)
RN  - 0 (HLA-DRB1 Chains)
SB  - IM
MH  - Adult
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - BNT162 Vaccine
MH  - *COVID-19
MH  - COVID-19 Vaccines/adverse effects
MH  - *Graves Disease
MH  - Histocompatibility Testing
MH  - HLA-DRB1 Chains
MH  - SARS-CoV-2
MH  - *Thyroiditis, Subacute/chemically induced/diagnosis/drug therapy
MH  - *Thyrotoxicosis
MH  - Vaccination
PMC - PMC9988595
OTO - NOTNLM
OT  - COVID-19
OT  - Case report
OT  - Graves' disease
OT  - HLA
OT  - SARS-CoV-2 vaccination
OT  - Subacute thyroiditis
COIS- The authors declare that they have no competing interests
EDAT- 2023/03/07 06:00
MHDA- 2023/03/09 06:00
PMCR- 2023/03/07
CRDT- 2023/03/06 23:31
PHST- 2022/06/10 00:00 [received]
PHST- 2023/01/27 00:00 [accepted]
PHST- 2023/03/06 23:31 [entrez]
PHST- 2023/03/07 06:00 [pubmed]
PHST- 2023/03/09 06:00 [medline]
PHST- 2023/03/07 00:00 [pmc-release]
AID - 10.1186/s12902-023-01287-5 [pii]
AID - 1287 [pii]
AID - 10.1186/s12902-023-01287-5 [doi]
PST - epublish
SO  - BMC Endocr Disord. 2023 Mar 7;23(1):54. doi: 10.1186/s12902-023-01287-5.