Infectious Disease

COVID vaccination may trigger thyroid eye disease flare

October 01, 2022

1 min read

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sources:

Kally P, et al. A growing concern: Thyroid eye disease activation following COVID-19 vaccination. Presented at: ASOPRS Fall Scientific Symposium; Sept. 29-30, 2022; Chicago.

Disclosures:
Kally reports no relevant financial relationships.

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CHICAGO — Ophthalmologists should monitor patients with thyroid eye disease when they receive their COVID-19 vaccinations, according to a small case study presented at the ASOPRS Fall Scientific Symposium.

“It stands to reason that the immune response that you may get from a COVID vaccine or any vaccination may also trigger an autoimmune response,” Peter Kally, MD, of Consultants in Ophthalmic and Facial Plastic Surgery and Beaumont Eye Institute in Michigan, said. “COVID vaccination is possibly associated with thyroid eye disease reactivation.”

Peter Kally quote: COVID vaccination is possibly associated with thyroid eye disease reactivation

Kally reported on a single-center case series of five patients with thyroid eye disease reactivation following their COVID-19 vaccination. The retrospective case series spanned from March 2020 to March 2022. The patients all had prior evaluation, including thyroid-specific tests and examinations, and presented with worsening thyroid eye disease after receiving their vaccinations.

The series included four women and one man with an average age of 60.2 years. The average presentation to clinic was 43 days after vaccination, with a range of 10 days to 65 days. Three patients received the Pfizer vaccination, one received the Moderna vaccination, and one received the Johnson & Johnson vaccination.

Looking at the labs, thyroid stimulating immunoglobulin (TSI) elevation and biochemical hyperthyroidism were present. Clinical activity score increased an average of 5 points, and Hertel measurement increased an average of 2.6 mm.

“TSI was a marker for current disease activity,” Kally said.

Four patients received oral or IV steroids, two required decompression, and two received Tepezza (teprotumumab, Horizon Therapeutics), he said. No irreversible vision loss occurred.

“Correlation does not prove causation with any of this … but this report is in alignment with other reports we have seen … triggering an autoimmune response after COVID-19 vaccination. Continued surveillance may help us guide our patient counseling for our thyroid eye disease patients,” Kally said. “We recommend that with your thyroid eye disease patients paying close attention to their COVID vaccine … time period for whether or not they have thyroid flares.”

“There’s a lot we don’t know still,” he said during a question-and-answer session.

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