接种 COVID-19 疫苗后新发和复发性 Graves 病：已报告病例的综合回顾。
New-onset and relapsed Graves' disease following COVID-19 vaccination: a comprehensive review of reported cases.
机构信息
Department of Endocrinology and Metabolism, The Institute of Endocrinology, NHC Key Laboratory of Diagnosis and Treatment of Thyroid Disease, The First Hospital of China Medical University, Shenyang, Liaoning, China.
出版信息
Eur J Med Res. 2023 Jul 13;28(1):232. doi: 10.1186/s40001-023-01210-7.
Global Coronavir us disease 2019 (COVID-19) vaccination efforts are being intensified to combat the pandemic. As the frequency of immunization against COVID-19 has increased, some adverse effects related to vaccination have emerged. Within this context, this article reviewed 62 Graves' disease (GD) cases following COVID-19 vaccination, to probe the potential association between the vaccination and the onset of GD. A comprehensive search of the PubMed, Web of Science, and Scopus databases was conducted to collect GD cases following COVID-19 vaccination up to June 7, 2023. Among the 62 GD cases included in this review, there were 33 (53.2%) new-onset GD and 10 (16.1%) relapsed GD patients following mRNA vaccination, 14 (22.6%) new-onset GD and 4 (6.5%) relapsed GD patients following viral vector vaccination, and 1 (1.6%) relapsed GD patients following inactivated vaccination. Median durations to symptoms onset for new-onset and relapsed GD were 12 (range: 1-60) and 21 (range: 5-30) days following mRNA vaccination, while 7 (range: 1-28) and 14 (range: 10-14) days following viral vector vaccination, respectively. While the definitive pathogenesis of GD following COVID-19 vaccination remains unclear, it might be associated with cross-immune responses triggered by molecular mimicry, and an adjuvant-induced autoimmune/inflammatory syndrome. However, due to the limited number of observed GD cases following COVID-19 vaccination and the lack of systematic experimental studies, a causal relationship between COVID-19 vaccination and the onset of GD has not been definitively confirmed. It should be highlighted that most of GD patients following COVID-19 vaccination experienced positive outcomes after treatment. In the broader context of ending the COVID-19 pandemic and reducing mortality rates, the benefits of COVID-19 vaccination significantly outweigh mild risks such as treatable GD. Adherence to the COVID-19 vaccination schedule is therefore imperative in effectively managing the pandemic.
全球 2019 年冠状病毒病（COVID-19）疫苗接种工作正在加紧进行，以应对这一大流行病。随着 COVID-19 疫苗接种频率的增加，一些与接种相关的不良反应已经出现。在这种情况下，本文综述了 62 例 COVID-19 疫苗接种后 Graves 病（GD）病例，以探讨疫苗接种与 GD 发病之间的潜在关联。全面检索了 PubMed、Web of Science 和 Scopus 数据库，收集截至 2023 年 6 月 7 日 COVID-19 疫苗接种后发生的 GD 病例。在本综述中纳入的 62 例 GD 病例中，有 33 例（53.2%）为 mRNA 疫苗接种后新发 GD，10 例（16.1%）为复发 GD；14 例（22.6%）为病毒载体疫苗接种后新发 GD，4 例（6.5%）为复发 GD；1 例（1.6%）为灭活疫苗接种后复发 GD。mRNA 疫苗接种后新发和复发 GD 的症状出现中位时间分别为 12（范围：1-60）和 21（范围：5-30）天，而病毒载体疫苗接种后分别为 7（范围：1-28）和 14（范围：10-14）天。虽然 COVID-19 疫苗接种后 GD 的明确发病机制尚不清楚，但可能与分子模拟触发的交叉免疫反应以及佐剂诱导的自身免疫/炎症综合征有关。然而，由于 COVID-19 疫苗接种后观察到的 GD 病例数量有限，并且缺乏系统的实验研究，因此尚未明确证实 COVID-19 疫苗接种与 GD 发病之间存在因果关系。值得强调的是，COVID-19 疫苗接种后大多数 GD 患者在治疗后取得了良好的转归。在结束 COVID-19 大流行和降低死亡率的更广泛背景下，COVID-19 疫苗接种的益处大大超过了可治疗的 GD 等轻度风险。因此，坚持 COVID-19 疫苗接种计划对于有效管理大流行至关重要。
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