J Korean Med Sci.  2022 Feb;37(6):e39. 10.3346/jkms.2022.37.e39.

Subacute Thyroiditis After Receiving the mRNA COVID-19 Vaccine (Moderna): The First Case Report and Literature Review in Korea

• Jhon M
• Lee SH
• Oh TH
• Kang HC

• KMID: 2526028
• DOI: http://doi.org/10.3346/jkms.2022.37.e39

Abstract

Subacute thyroiditis (SAT) is a painful thyroiditis that often requires steroid therapy. Here, we report the first case of severe SAT in a patient who received the first dose of mRNA coronavirus disease 2019 (COVID-19) vaccination. A 34-year-old man without a viral prodrome felt a lump when swallowing 5 days after his first dose of mRNA-1273 (Moderna) vaccination. Ten days after , the patient visited the hospital and was advised to rest and take nonsteroidal anti-inflammatory drugs. He revisited the hospital 10 days later as symptoms aggravated with anterior neck pain, headache, fatigue, muscle weakness, and weight loss. Thyroid hormone levels and inflammatory markers were consistent with thyrotoxicosis. A thyroid ultrasound scan revealed typical SAT findings. His symptoms rapidly improved after receiving prednisone. A week later, the patient successfully completed his second dose of the vaccine. The thyroid function test results were nearly normal 1 month after the completion of the vaccination. We report this case to raise awareness of the occurrence of SAT after COVID-19 vaccination. As the risk of COVID-19 outweighs the minor risks of the vaccine, managing the side effects of the first vaccine dose is crucial to complete COVID-19 vaccination.

Keyword

COVID-19; COVID-19 Vaccines; mRNA-1273 Vaccine; Subacute Thyroiditis; Anterior Neck Pain

Figure

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  Fig. 1 Timeline of the symptoms, diagnosis and treatment of subacute thyroiditis after mRNA-1273 vaccination (Moderna).nCoV-PCR = novel coronavirus polymerase chain reaction, ECG = electrocardiogram, TFT = thyroid function tests, US = ultrasound scan, ESR = erythrocyte sedimentation rate, TSH = thyroid-stimulating hormone.

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  Fig. 2 Thyroid US image demonstrates enlarged thyroid gland (1.97 × 2.20 cm) with heterogeneous echotexture granuloma at the patient’s second visit to hospital.US = ultrasound scan.

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