ABSTRACT
Introduction: Subacute thyroiditis and autoimmune thyroiditis are known complications of COVID-19 infection. With the development of SARS-CoV-2 vaccine, new cases of thyroiditis following vaccination have been reported. In accordance, we report on a series of patients who present with hyperthyroidism, elevated TSH receptor activating antibodies, concerning for activation of Graves disease after receiving SARS-Cov-2 messenger RNA (mRNA) vaccine. This association underpins the possible immune modulation affecting the presentation of autoimmune thyroiditis post vaccination. Case Description: We describe four patients who present with symptoms of hyperthyroidism after receiving SARS-CoV-2 mRNA vaccine. All were females, median age 49 (range 44-59). Two patients presented with de novo hyperthyroidism 25-29 days following SARS-CoV-2 mRNA vaccine. Two patients have previously had diagnosed Graves disease in remission for longer than 3 years and presented after 40-60 days after receiving SARS-CoV-2 mRNA vaccine. All four patients had TSH receptor antibodies positive (range 6.21-11.87IU/L) Discussion: Although vaccines are one of the most successful medical advances clarifying associated conditions and risks is of interest to practicing physicians. It is not known if these 4 cases of Graves disease were diagnosed coincidentally following SARS-CoV-2 vaccine and association between this vaccine and autoimmune manifestations remains to be further investigated. This report adds information to current knowledge and understanding of autoimmune manifestations following SARS-CoV-2 vaccine.Copyright © 2023