Sex: F
Vaccine: COVID19
Symptoms: Tri-iodothyronine, Ultrasound thyroid
Clinical narrative: thyrotoxicosis; Thyroiditis; Myalgia; Fatigue; Nausea; Chills; This is a literature report. A 57-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection. Batch/Lot number was not reported), dose 1 via an unspecified route of administration on an unspecified date as DOSE 1, SINGLE for COVID-19 immunization. The patient medical and concomitant medication history were reported. It was reported that, rapid COVID-19 vaccine development and uptake are critical to mitigating the ongoing epidemic. Current vaccine candidates are at various stages of development and regulatory approval. These vaccines are broadly considered safe, though adverse effects have not yet been fully characterized. In this study we present the first description of thyroiditis linked to SARS-CoV-2 vaccination. It was mentioned that, no medical history received the first dose of the Pfizer-BioNTech SARS-CoV-2 vaccine 34 days before presentation, with associated fatigue, nausea, chills, and myalgias lasting 1.5 days. Patient received the second dose 13 days before presentation, and within 24 hours had recurrence of symptoms associated with new progressive anterior neck pain and swelling. Patient was referred to the hospital by out-patient provider for thyrotropin (TSH) 0.009 uU/mL, thyroxine (T4) free 2.6 ng/dL, and T4 total 17.4 mcg/dL (outpatient normal ranges [NRs] unavailable). On hospital arrival, patient was febrile to 38.3 Centigrade with a pulse of 137 beats/min. Examination revealed right thyroid gland enlargement with diffuse tenderness, and no proptosis, lid lag, or periorbital edema. Laboratories showed TSH <0.008 uU/mL (NR: 0.4-4.2), free T4 1.92 ng/dL (NR: 0.8-1.5), triiodothyronine (T3) total 137 ng/dL (NR: 87-178) with thyrotropin receptor antibody <1.10 U/L (NR: 0-1.75), thyroid stimulating immunoglobulin <0.10 U/L (NR: 0-0.55), thyroid peroxidase antibody <0.5 U/mL (NR: 0-5.6), and thyroglobulin antibody 3.4 U/mL (NR: 0-4.1). Thyroid ultrasound showed an asymmetrically enlarged hypervascular heterogeneous right thyroid lobe suggestive of thyroiditis. The patient underwent lab tests and procedures which included antithyroid antibody: 3.4 IU/ml, antithyroid antibody: less than 0.5 IU/ml, antithyroid antibody positive: less than 1.10 IU/ml, blood thyroid stimulating hormone: 0.009 uiu/ml and less than 0.008 uiu/ml, body temperature: 38.3 centigrade febrile, heart rate: 137 beats/min, physical examination: revealed right thyroid gland enlargement with diff revealed right thyroid gland enlargement with diffuse tenderness, and no proptosis, lid lag, or periorbital edema, thyroid stimulating immunoglobulin: less than 0.10 iu/l, thyroxine: 17.4 ug/dl, thyroxine free: 2.6 ng/dl and thyroxine free: 1.92 ng/dl, tri-iodothyronine: 137 ng/dl, ultrasound thyroid: showed an asymmetrically enlarged hypervascular, showed an asymmetrically enlarged hypervascular heterogeneous right thyroid lobe suggestive of thyroiditis. Patient was treated with propranolol and ibuprofen and later started on prednisone as an outpatient. The outcome of the event hyperthyroidism and thyroiditis were unknown while other events were recovered on 2021.