New-Onset Graves’ Disease and Type 1 Diabetes After COVID-19 and Anti-SARS-CoV-2 Vaccination
摘要
COVID-19 was shown to involve multiple extra-respiratory organs also leading to the occurrence of different autoimmune and endocrine pathological features. Several cases of newly diagnosed Graves’ disease and type 1 diabetes after SARS-CoV-2 infection have been progressively described, and were mostly related to the disruptions of immune system typically present in COVID-19 patients and frequently triggering autoimmunity. Noteworthy, although anti-SARS-CoV-2 vaccinations have shown an excellent safety profile with very few adverse events reported, autoimmune disorders following vaccine administrations, also including Graves’ disease and type 1 diabetes, have been consistently reported. These conditions were related to the potential occurrence of molecular mimicry processes or autoimmune syndromes induced by adjuvants triggered by the vaccine excipients. Interestingly, the postvaccination forms of Graves’ disease have been characterized by distinctive different epidemiological pattern as compared to the wild-type forms reinforcing the potential causal association with vaccine administration. An early and prompt diagnosis of these conditions is recommended possibly including active surveillance with thyroid and glucometabolic functions in patients with persistent symptoms occurring after vaccination and in those with personal or familiar history of autoimmune diseases.