COVID vaccination may trigger thyroid eye disease flare

October 01, 2022

1 minute read



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

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 vaccines, according to a small case study presented at the ASOPRS Fall Scientific Symposium.

“It stands to reason that the immune response you can get from a COVID vaccine or any vaccination can also trigger an autoimmune response,” Peter Kally, MD, ophthalmic and facial plastic surgery consultants and Beaumont Eye Institute in Michigan, said. “COVID vaccination may be associated with reactivation of thyroid eye disease.”

Quote from Peter Kally: COVID vaccination may be associated with reactivation of thyroid eye disease

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

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

Looking at labs, elevated thyroid-stimulating immunoglobulins (TSI) and biochemical hyperthyroidism were present. The clinical activity score increased by an average of 5 points and the Hertel measurement increased by an average of 2.6 mm.

“TSI was a marker of 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.

“The correlation proves no causation with any of this…but this report is consistent with other reports we have seen…triggering an autoimmune response after COVID-19 vaccination. Ongoing monitoring can help guide our patient counseling for our patients with thyroid eye disease,” Kally said. “We recommend that patients with thyroid eye disease pay close attention to their COVID vaccine…period of time to know whether or not they have thyroid flare-ups.”

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

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