{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:08:03Z","timestamp":1790611683687,"version":"4.1.0"},"reference-count":45,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T00:00:00Z","timestamp":1663718400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Several case reports of Graves\u2019 disease (GD) occurrence after COVID-19 vaccination that are possibly related to the autoimmune syndrome induced by adjuvants (ASIA) were published recently.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The aim of our study was to evaluate possible distinctive features in the presentation and clinical course of patients with GD occurring early (within 4 weeks) after COVID-19 vaccination who attended our Endocrine Unit in 2021.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Patients with a first episode of GD attending a tertiary endocrine center between January 1, 2021, and December 31, 2021, were included.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sixty-four patients with a first episode of GD were seen in 2021: 20 (31.2%) of them had onset within 4 weeks following vaccine administration. Compared with the other 44 patients, the 20 patients with postvaccine early-onset (PoVEO) GD were older (median age 51 years vs 35 years, P = .003) and more likely to be male (40.0% vs 13.6%, P = .018). At diagnosis, the biochemical and immune profiles were similar between the 2 groups. However, at 3 months after starting methimazole, patients with PoVEO GD had significantly lower thyrotropin receptor antibody titer and were taking lower doses of methimazole than the other patients with GD. None in the PoVEO group had sustained free triiodothyronine elevation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This relatively large series suggests that in 2021 PoVEO GD may be a new nosologic entity representing one-third of patients evaluated for new-onset GD in our center. Distinctive features included older age at onset, higher male prevalence, and a better initial biochemical and immunologic response to treatment. Further studies are warranted to clinically and biochemically differentiate these cases from sporadically occurring GD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgac550","type":"journal-article","created":{"date-parts":[[2022,9,21]],"date-time":"2022-09-21T20:50:27Z","timestamp":1663793427000},"page":"107-113","source":"Crossref","is-referenced-by-count":24,"title":["Distinct Clinical Features of Post-COVID-19 Vaccination Early-onset Graves\u2019 Disease"],"prefix":"10.1210","volume":"108","author":[{"given":"Luigi","family":"di Filippo","sequence":"first","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Castellino","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnese","family":"Allora","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Frara","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Lanzi","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Perticone","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Valsecchi","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Vassallo","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Giubbini","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifford J","family":"Rosen","sequence":"additional","affiliation":[{"name":"Center for Clinical and Translational Research, Maine Medical Center Research Institute , Scarborough, ME 04074 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6783-3398","authenticated-orcid":false,"given":"Andrea","family":"Giustina","sequence":"additional","affiliation":[{"name":"Institute of Endocrine and Metabolic Sciences, Universit\u00e0 Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele , Milan 20132 , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2022,9,21]]},"reference":[{"key":"2022121716480087700_dgac550-B1"},{"key":"2022121716480087700_dgac550-B2","author":"World Health Organization (WHO)"},{"issue":"27","key":"2022121716480087700_dgac550-B3","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N Engl J Med"},{"issue":"5","key":"2022121716480087700_dgac550-B4","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1056\/NEJMoa2035389","article-title":"Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine","volume":"384","author":"Baden","year":"2021","journal-title":"N Engl J Med"},{"issue":"10269","key":"2022121716480087700_dgac550-B5","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S0140-6736(20)32661-1","article-title":"Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK [published correction appears in Lancet. 2021 Jan 9; 397(10269):98]","volume":"397","author":"Voysey","year":"2021","journal-title":"Lancet"},{"issue":"6","key":"2022121716480087700_dgac550-B6","doi-asserted-by":"crossref","first-page":"1189","DOI":"10.1007\/s40618-022-01747-0","article-title":"SARS-CoV-2 vaccine-associated subacute thyroiditis: insights from a systematic review","volume":"45","author":"Ippolito","year":"2022","journal-title":"J Endocrinol Invest"},{"issue":"9","key":"2022121716480087700_dgac550-B7","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1089\/thy.2021.0142","article-title":"Two cases of Graves\u2019 disease following SARS-CoV-2 vaccination: an autoimmune\/inflammatory syndrome induced by adjuvants","volume":"31","author":"Vera-Lastra","year":"2021","journal-title":"Thyroid"},{"issue":"1","key":"2022121716480087700_dgac550-B8","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1007\/s40618-021-01650-0","article-title":"Two further cases of Graves\u2019 disease following SARS-Cov-2 vaccination","volume":"45","author":"Zettinig","year":"2022","journal-title":"J Endocrinol Invest"},{"issue":"1","key":"2022121716480087700_dgac550-B9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s12020-021-02919-3","article-title":"Occurrence and response to treatment of Graves\u2019 disease after COVID vaccination in two male patients","volume":"75","author":"di Filippo","year":"2022","journal-title":"Endocrine"},{"issue":"6","key":"2022121716480087700_dgac550-B10","doi-asserted-by":"crossref","first-page":"e2324","DOI":"10.1210\/clinem\/dgac119","article-title":"SARS-CoV-2 mRNA vaccination and Graves\u2019 disease: a report of 12 cases and review of the literature","volume":"107","author":"Chee","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"2022121716480087700_dgac550-B11","doi-asserted-by":"crossref","first-page":"102738","DOI":"10.1016\/j.jaut.2021.102738","article-title":"A case of Graves\u2019 disease and type 1 diabetes mellitus following SARS-CoV-2 vaccination","volume":"125","author":"Patrizio","year":"2021","journal-title":"J Autoimmun"},{"issue":"5","key":"2022121716480087700_dgac550-B12","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1007\/s40618-022-01739-0","article-title":"Thyrotoxicosis following SARS-COV-2 vaccination: a case series and discussion","volume":"45","author":"Pla Peris","year":"2022","journal-title":"J Endocrinol Invest"},{"key":"2022121716480087700_dgac550-B13","article-title":"Graves disease following the SARS-CoV-2 vaccine: case series","volume":"9","author":"Weintraub","year":"2021","journal-title":"J Investig Med High Impact Case Rep"},{"issue":"1","key":"2022121716480087700_dgac550-B14","doi-asserted-by":"crossref","first-page":"101412","DOI":"10.1016\/j.beem.2020.101412","article-title":"ASIA Syndrome and endocrine autoimmune disorders","volume":"34","author":"Bragazzi","year":"2020","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"1","key":"2022121716480087700_dgac550-B15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.jaut.2010.07.003","article-title":"\u2018ASIA\u2019\u2014autoimmune\/inflammatory syndrome induced by adjuvants","volume":"36","author":"Shoenfeld","year":"2011","journal-title":"J Autoimmun"},{"issue":"2","key":"2022121716480087700_dgac550-B16","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s10067-017-3748-9","article-title":"The autoimmune\/inflammatory syndrome induced by adjuvants (ASIA)\/Shoenfeld's syndrome: descriptive analysis of 300 patients from the international ASIA syndrome registry","volume":"37","author":"Watad","year":"2018","journal-title":"Clin Rheumatol"},{"key":"2022121716480087700_dgac550-B17","doi-asserted-by":"crossref","first-page":"108480","DOI":"10.1016\/j.clim.2020.108480","article-title":"Potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases","volume":"217","author":"Vojdani","year":"2020","journal-title":"Clin Immunol"},{"issue":"4","key":"2022121716480087700_dgac550-B18","doi-asserted-by":"crossref","first-page":"102792","DOI":"10.1016\/j.autrev.2021.102792","article-title":"The SARS-CoV-2 as an instrumental trigger of autoimmunity","volume":"20","author":"Dotan","year":"2021","journal-title":"Autoimmun Rev"},{"key":"2022121716480087700_dgac550-B19","doi-asserted-by":"crossref","first-page":"617089","DOI":"10.3389\/fimmu.2020.617089","article-title":"Reaction of human monoclonal antibodies to SARS-CoV-2 proteins with tissue antigens: implications for autoimmune diseases","volume":"11","author":"Vojdani","year":"2021","journal-title":"Front Immunol"},{"issue":"10","key":"2022121716480087700_dgac550-B20","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1089\/thy.2016.0229","article-title":"2016 American thyroid association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis [published correction appears in Thyroid. 2017 Nov; 27(11):1462]","volume":"26","author":"Ross","year":"2016","journal-title":"Thyroid"},{"key":"2022121716480087700_dgac550-B21","doi-asserted-by":"crossref","first-page":"900964","DOI":"10.3389\/fendo.2022.900964","article-title":"Thyroid inconveniences with vaccination against SARS-CoV-2: the size of the matter. A systematic review","volume":"13","author":"Caironi","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"1","key":"2022121716480087700_dgac550-B22","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1186\/s43162-022-00129-5","article-title":"Immune-mediated adverse events post-COVID vaccination and types of vaccines: a systematic review and meta-analysis","volume":"34","author":"ElSawi","year":"2022","journal-title":"Egypt J Intern Med"},{"issue":"1","key":"2022121716480087700_dgac550-B23","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1186\/s12916-021-02059-5","article-title":"Evaluation of the safety profile of COVID-19 vaccines: a rapid review","volume":"19","author":"Wu","year":"2021","journal-title":"BMC Med"},{"key":"2022121716480087700_dgac550-B24"},{"key":"2022121716480087700_dgac550-B25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12020-022-03118-4","article-title":"Autoimmune and inflammatory thyroid diseases following vaccination with SARS-CoV-2 vaccines: from etiopathogenesis to clinical management","author":"Caron","year":"2022","journal-title":"Endocrine"},{"key":"2022121716480087700_dgac550-B26","article-title":"Thyroid dysfunction following vaccination with COVID-19 vaccines: a basic review of the preliminary evidence","author":"Jafarzadeh","journal-title":"J Endocrinol Invest"},{"issue":"2","key":"2022121716480087700_dgac550-B27","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s11154-022-09716-x","article-title":"Revisiting the endocrine and metabolic manifestations of COVID-19 two years into the pandemic","volume":"23","author":"Giustina","year":"2022","journal-title":"Rev Endocr Metab Disord"},{"issue":"2","key":"2022121716480087700_dgac550-B28","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1007\/s12020-021-02734-w","article-title":"COVID-19 and endocrine and metabolic diseases. An updated statement from the European Society of Endocrinology","volume":"72","author":"Puig-Domingo","year":"2021","journal-title":"Endocrine"},{"issue":"1","key":"2022121716480087700_dgac550-B29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s12020-021-02671-8","article-title":"Hypovitaminosis D and the endocrine phenotype of COVID-19","volume":"72","author":"Giustina","year":"2021","journal-title":"Endocrine"},{"issue":"8","key":"2022121716480087700_dgac550-B30","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1038\/s41574-021-00516-y","article-title":"The emerging osteo-metabolic phenotype of COVID-19: clinical and pathophysiological aspects","volume":"17","author":"di Filippo","year":"2021","journal-title":"Nat Rev Endocrinol"},{"issue":"9","key":"2022121716480087700_dgac550-B31","doi-asserted-by":"crossref","first-page":"e3781","DOI":"10.1210\/clinem\/dgac355","article-title":"Effect of COVID-19 vaccines on thyroid function and autoimmunity and effect of thyroid autoimmunity on antibody response","volume":"107","author":"Lui","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"2022121716480087700_dgac550-B32","doi-asserted-by":"crossref","first-page":"840668","DOI":"10.3389\/fendo.2022.840668","article-title":"Patients with autoimmune thyroiditis present similar immunological response to COVID-19 BNT162b2 mRNA vaccine with healthy subjects, while vaccination may affect thyroid function: a clinical study","volume":"13","author":"Paschou","year":"2022","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"5","key":"2022121716480087700_dgac550-B33","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1089\/thy.2021.0684","article-title":"Safety of inactivated and mRNA COVID-19 vaccination among patients treated for hypothyroidism: a population-based cohort study","volume":"32","author":"Xiong","year":"2022","journal-title":"Thyroid"},{"key":"2022121716480087700_dgac550-B34"},{"key":"2022121716480087700_dgac550-B35"},{"issue":"9","key":"2022121716480087700_dgac550-B36","doi-asserted-by":"crossref","first-page":"14022","DOI":"10.1021\/acsnano.1c05922","article-title":"Polyethylene glycol immunogenicity: theoretical, clinical, and practical aspects of anti-polyethylene glycol antibodies","volume":"15","author":"Chen","year":"2021","journal-title":"ACS Nano"},{"issue":"6","key":"2022121716480087700_dgac550-B37","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1111\/cea.13874","article-title":"Polyethylene glycol (PEG) is a cause of anaphylaxis to the Pfizer\/BioNTech mRNA COVID-19 vaccine","volume":"51","author":"Sellaturay","year":"2021","journal-title":"Clin Exp Allergy"},{"key":"2022121716480087700_dgac550-B38","doi-asserted-by":"crossref","first-page":"e106","DOI":"10.1016\/j.bja.2020.12.020","article-title":"Anaphylaxis to the first COVID-19 vaccine: is polyethylene glycol (PEG) the culprit?","volume":"126","author":"Garvey","year":"2021","journal-title":"Br J Anaesth"},{"issue":"7","key":"2022121716480087700_dgac550-B39","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1111\/cea.12760","article-title":"Immediate-type hypersensitivity to polyethylene glycols: a review","volume":"46","author":"Wenande","year":"2016","journal-title":"Clin Exp Allergy"},{"issue":"2","key":"2022121716480087700_dgac550-B40","doi-asserted-by":"crossref","first-page":"670","DOI":"10.1016\/j.jaip.2020.09.029","article-title":"Polyethylene glycol-induced systemic allergic reactions (anaphylaxis)","volume":"9","author":"Sellaturay","year":"2021","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2022121716480087700_dgac550-B41"},{"issue":"24","key":"2022121716480087700_dgac550-B42","doi-asserted-by":"crossref","first-page":"3167","DOI":"10.1016\/j.vaccine.2019.04.055","article-title":"Vaccine adjuvants: understanding the structure and mechanism of adjuvanticity","volume":"37","author":"Shi","year":"2019","journal-title":"Vaccine"},{"issue":"10","key":"2022121716480087700_dgac550-B43","doi-asserted-by":"crossref","first-page":"3546","DOI":"10.1016\/j.jaip.2021.06.006","article-title":"The risk of allergic reaction to SARS-CoV-2 vaccines and recommended evaluation and management: a systematic review, meta-analysis, GRADE assessment, and international consensus approach","volume":"9","author":"Greenhawt","year":"2021","journal-title":"J Allergy Clin Immunol Pract"},{"issue":"16","key":"2022121716480087700_dgac550-B44","doi-asserted-by":"crossref","first-page":"1552","DOI":"10.1056\/NEJMra1510030","article-title":"Graves\u2019 disease","volume":"375","author":"Smith","year":"2016","journal-title":"N Engl J Med"},{"issue":"1","key":"2022121716480087700_dgac550-B45","doi-asserted-by":"crossref","first-page":"101387","DOI":"10.1016\/j.beem.2020.101387","article-title":"Graves\u2019 disease: epidemiology, genetic and environmental risk factors and viruses","volume":"34","author":"Antonelli","year":"2020","journal-title":"Best Pract Res Clin Endocrinol Metab"}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgac550\/46538742\/dgac550.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/108\/1\/107\/48076722\/dgac550.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/108\/1\/107\/48076722\/dgac550.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,17]],"date-time":"2022-12-17T16:48:21Z","timestamp":1671295701000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/108\/1\/107\/6708407"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,21]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,9,21]]},"published-print":{"date-parts":[[2022,12,17]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgac550","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,1,1]]},"published":{"date-parts":[[2022,9,21]]}}}