Aim To describe a case series of thyrotoxicosis likely triggered by SARS-CoV-2 vaccination and to warn physicians about
this potential correlation. To report clinical, laboratory and imaging fndings and provide further information that goes in
line with the underlying mechanisms.
Methods Single-center case series based on all the information collected in the hospital medical records, as well as the
temporal sequence between the onset of symptoms and COVID-19 vaccination.
Results We report 8 cases with thyrotoxicosis after SARS-CoV-2 vaccination. 4 cases of Graves’ disease (GD), 2 cases of
subacute painful thyroiditis (SAT), 1 case of concurrent GD and SAT and 1 case of atypical subacute thyroiditis. Five patients
received BNT162b2 mRNA vaccine, 3 patients 1273 mRNA vaccine. The onset of symptoms following vaccination ranged
from 10 to 14 days in six of eight patients and from 7 to 8 weeks in two patients.
Conclusions Several hypotheses have been proposed to explain the potential correlation between SARS-CoV-2 vaccination
and thyrotoxicosis, including immune system hyper-stimulation, molecular mimicry and Autoimmune/Autoinfammatory
Syndrome Induced by Adjuvants (ASIA). We should pay greater attention to thyroid disorders in patients receiving vaccine
against SARS-CoV-2
