Sex: U
Vaccine: COVID19
Symptoms: Endocrine ophthalmopathy, Thyroid stimulating immunoglobulin
Clinical narrative: Thyroid eye disease reactivation; This literature-non-study case was reported in a literature article and describes the occurrence of ENDOCRINE OPHTHALMOPATHY (Thyroid eye disease reactivation) in a  patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 prophylaxis.   LITERATURE REFERENCE:    Concurrent medical conditions included Thyroid eye disease.  On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced ENDOCRINE OPHTHALMOPATHY (Thyroid eye disease reactivation) (seriousness criterion medically significant). At the time of the report, ENDOCRINE OPHTHALMOPATHY (Thyroid eye disease reactivation) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Thyroid stimulating immunoglobulin: increased activity, marker of disease activity.   The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   No concomitant and treatment medications were reported.  The retrospective case series spanned from March 2020 to March 2022.  The patient had prior revaluation, including thyroid-specific tests and examinations, and presented with worsening thyroid eye disease after receiving the vaccination.  No irreversible vision loss occurred.  It was reported that TSI was a marker for current disease activity. Biochemical hyperthyroidism was present. Clinical activity score increased an average of 5 points and Hertel measurement increased an average of 2.6 mm.  Author noted that correlation does not prove causation with any of this but this report was in alignment with other reports that were seen triggering an autoimmune response after COVID-19 vaccination. Continued surveillance might help us guide the patient counseling for thyroid eye disease patients.  Author also recommended that the with the thyroid eye disease, patients should be paid close attention to their COVID vaccine time period for whether or not they have thyroid flares.  Company Comment: This literature non-study case concerns a patient of unknown age and sex with an underlying thyroid eye disease, who experienced an unexpected, medically significant event of Endocrine ophthalmopathy (reported as Thyroid eye disease reactivation) after receiving a dose of mRNA-1273 vaccine. Exact onset latency of the event cannot be determined with unknown event's start date and vaccination date. The average presentation to clinic after vaccination ranged from 10 days to 65 days. Pre- and post-vaccination evaluations were done. The reported post-vaccination findings of elevated thyroid stimulating immunoglobulin (a marker of disease activity), biochemical hyperthyroidism, an average increase of 5 points in the clinical activity score, and an average increase of 2.6 mm in Hertel measurement were not specific to this patient. Reported treatments with oral or intravenous steroids, decompression, and Teprotumumab were not specific to this patient. No irreversible vision loss occurred per the authors. The authors stated that correlation of thyroid eye disease reactivation with the vaccine does not prove causation. Underlying thyroid eye disease remains a confounder in this case. The benefit-risk relationship of mRNA-1273 is not affected by this report. Event's seriousness assessed per medical judgement. Sender's Comments: This literature non-study case concerns a patient of unknown age and sex with an underlying thyroid eye disease, who experienced an unexpected, medically significant event of Endocrine ophthalmopathy (reported as Thyroid eye disease reactivation) after receiving a dose of mRNA-1273 vaccine. Exact onset latency of the event cannot be determined with unknown event's start date and vaccination date. The average presentation to clinic after vaccination ranged from 10 days to 65 days. Pre- and post-vaccination evaluations were done. The reported post-vaccination findings of elevated thyroid stimulating immunoglobulin (a marker of disease activity), biochemical hyperthyroidism, an average increase of 5 points in the clinical activity score, and an average increase of 2.6 mm in Hertel measurement were not specific to this patient. Reported treatments with oral or intravenous steroids, decompression, and Teprotumumab were not specific to this patient. No irreversible vision loss occurred per the authors. The authors stated that correlation of thyroid eye disease reactivation with the vaccine does not prove causation. Underlying thyroid eye disease remains a confounder in this case. The benefit-risk relationship of mRNA-1273 is not affected by this report. Event's seriousness assessed per medical judgement.