{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T05:46:40Z","timestamp":1761976000664,"version":"build-2065373602"},"reference-count":83,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Since the emergence of the COVID-19 pandemic at the end of 2019, a massive vaccination campaign has been undertaken rapidly and worldwide. Like other vaccines, the COVID-19 vaccine is not devoid of side effects. Typically, the adverse side effects of vaccination include transient headache, fever, and myalgia. Endocrine organs are also affected by adverse effects. The major SARS-CoV-2 vaccine-associated endocrinopathies reported since the beginning of the vaccination campaign are thyroid and pancreas disorders. SARS-CoV-2 vaccine-induced pituitary diseases have become more frequently described in the literature. We searched PubMed\/MEDLINE for commentaries, case reports, and case series articles reporting pituitary disorders following SARS-CoV-2 vaccination. The search was reiterated until September 2022, in which eight case reports were found. In all the cases, there were no personal or familial history of pituitary disease described. All the patients described had no previous SARS-CoV-2 infection prior to the vaccination episode. Regarding the type of vaccines administered, 50% of the patients received (BNT162b2; Pfizer\u2013BioNTech) and 50% received (ChAdOx1 nCov-19; AstraZeneca). In five cases, the pituitary disorder developed after the first dose of the corresponding vaccine. Regarding the types of pituitary disorder, five were hypophysitis (variable clinical aspects ranging from pituitary lesion to pituitary stalk thickness) and three were pituitary apoplexy. The time period between vaccination and pituitary disorder ranged from one to seven days. Depending on each case\u2019s follow-up time, a complete remission was obtained in all the apoplexy cases but in only three patients with hypophysitis (persistence of the central diabetes insipidus). Both quantity and quality of the published data about pituitary inconveniences after COVID-19 vaccination are limited. Pituitary disorders, unlike thyroid disorders, occur very quickly after COVID-19 vaccination (less than seven days for pituitary disorders versus two months for thyroid disease). This is partially explained by the ease of reaching the pituitary, which is a small gland. Therefore, this gland is rapidly overspread, which explains the speed of onset of pituitary symptoms (especially ADH deficiency which is a rapid onset deficit with evocative symptoms). Accordingly, these pilot findings offer clinicians a future direction to be vigilant for possible pituitary adverse effects of vaccination. This will allow them to accurately orient patients for medical assistance when they present with remarkable symptoms, such as asthenia, polyuro-polydipsia, or severe headache, following a COVID-19 vaccination.<\/jats:p>","DOI":"10.3390\/vaccines10122004","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T02:29:23Z","timestamp":1669343363000},"page":"2004","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Pilot Findings on SARS-CoV-2 Vaccine-Induced Pituitary Diseases: A Mini Review from Diagnosis to Pathophysiology"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8387-8278","authenticated-orcid":false,"given":"Ach","family":"Taieb","sequence":"first","affiliation":[{"name":"Department of Endocrinology, University Hospital of Farhat Hached Sousse, Sousse 4000, Tunisia"},{"name":"Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia"},{"name":"Laboratory of Exercice Physiology and Pathophysiology, Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5717-3875","authenticated-orcid":false,"given":"El Euch","family":"Mounira","sequence":"additional","affiliation":[{"name":"Faculty of Medicine of Sousse, University of Sousse, Sousse 4000, Tunisia"},{"name":"Department of Internal Medicine, University Hospital of Charles Nicoles, Tunis 4074, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"476","DOI":"10.3389\/fcell.2020.00476","article-title":"Recent Understandings Toward Coronavirus Disease 2019 (COVID-19): From Bench to Bedside","volume":"8","author":"Yu","year":"2020","journal-title":"Front. Cell Dev. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1983","DOI":"10.1007\/s42399-020-00546-z","article-title":"The SARS-CoV-2 Outbreak: An Epidemiological and Clinical Perspective","volume":"2","author":"Wong","year":"2020","journal-title":"SN Compr. Clin. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"526","DOI":"10.3389\/fmed.2020.00526","article-title":"Pulmonary and Extra-Pulmonary Clinical Manifestations of COVID-19","volume":"7","author":"Johnson","year":"2020","journal-title":"Front. Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Rabail, R., Ahmed, W., Ilyas, M., Rajoka, M.S.R., Hassoun, A., Khalid, A.R., Khan, M.R., and Aadil, R.M. (2022). The Side Effects and Adverse Clinical Cases Reported after COVID-19 Immunization. Vaccines, 10.","DOI":"10.3390\/vaccines10040488"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s12020-022-03119-3","article-title":"Influence of COVID-19 vaccines on endocrine system","volume":"78","author":"Zhao","year":"2022","journal-title":"Endocrine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"757","DOI":"10.3803\/EnM.2021.404","article-title":"COVID-19 Vaccination for Endocrine Patients: A Position Statement from the Korean Endocrine Society","volume":"36","author":"Ku","year":"2021","journal-title":"Endocrinol. Metab."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/s11154-021-09678-6","article-title":"Basic mechanisms of SARS-CoV-2 infection. What endocrine systems could be implicated?","volume":"23","author":"Soldevila","year":"2022","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"R45","DOI":"10.1530\/JOE-20-0260","article-title":"Endocrine aspects of ACE2 regulation: RAAS, steroid hormones and SARS-CoV-2","volume":"247","author":"Young","year":"2020","journal-title":"J. Endocrinol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"381","DOI":"10.4103\/ijem.IJEM_440_20","article-title":"Endocrine Involvement in COVID-19: Mechanisms, Clinical Features, and Implications for Care","volume":"24","author":"Garg","year":"2020","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Lisco, G., De Tullio, A., Stragapede, A., Solimando, A., Albanese, F., Capobianco, M., Giagulli, V., Guastamacchia, E., De Pergola, G., and Vacca, A. (2021). COVID-19 and the Endocrine System: A Comprehensive Review on the Theme. J. Clin. Med., 10.","DOI":"10.3390\/jcm10132920"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"184","DOI":"10.3390\/idr14020023","article-title":"COVID-19 and the Endocrine System: A Review of the Current Information and Misinformation","volume":"14","author":"Mirza","year":"2022","journal-title":"Infect. Dis. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2366","DOI":"10.1080\/21645515.2020.1787064","article-title":"Perspectives on development of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)","volume":"16","author":"Zhang","year":"2020","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e0001422","DOI":"10.1128\/cmr.00014-22","article-title":"Sensitivity to Vaccines, Therapeutic Antibodies, and Viral Entry Inhibitors and Advances To Counter the SARS-CoV-2 Omicron Variant","volume":"35","author":"Zhou","year":"2022","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_14","first-page":"13","article-title":"Thyroid Inconveniences With Vaccination Against SARS-CoV-2: The Size of the Matter. A Systematic Review","volume":"1206","author":"Caironi","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Patrizio, A., Ferrari, S.M., Elia, G., Ragusa, F., Paparo, S.R., Mazzi, V., Antonelli, A., and Fallahi, P. (2022). Graves\u2019 Disease Following SARS-CoV-2 Vaccination: A Systematic Review. Vaccines, 10.","DOI":"10.3390\/vaccines10091445"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1016\/j.pcd.2022.05.009","article-title":"Risk of incident diabetes post-COVID-19: A systematic review and meta-analysis","volume":"16","author":"Banerjee","year":"2022","journal-title":"Prim. Care Diabetes"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.2169\/internalmedicine.9004-21","article-title":"New-onset Type 1 Diabetes after COVID-19 mRNA Vaccination","volume":"61","author":"Yano","year":"2022","journal-title":"Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.aace.2022.04.004","article-title":"Adrenal Crisis Secondary to COVID-19 Vaccination in a Patient With Hypopituitarism","volume":"8","author":"Markovic","year":"2022","journal-title":"AACE Clin. Case Rep."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Alexandraki, K.I., and Grossman, A. (2019). Management of Hypopituitarism. J. Clin. Med., 8.","DOI":"10.3390\/jcm8122153"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"3888","DOI":"10.1210\/jc.2016-2118","article-title":"Hormonal Replacement in Hypopituitarism in Adults: An Endocrine Society Clinical Practice Guideline","volume":"101","author":"Fleseriu","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1089\/thy.2014.0028","article-title":"Guidelines for the treatment of hypothyroidism: Prepared by the american thyroid association task force on thyroid hormone replacement","volume":"24","author":"Jonklaas","year":"2014","journal-title":"Thyroid. Off. J. Am. Thyroid. Assoc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1507\/endocrj.EJ18-0147","article-title":"Cortisol cut-points for the glucagon stimulation test in the evaluation of hypothalamic pituitary adrenal axis","volume":"65","author":"Ach","year":"2018","journal-title":"Endocr. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"bvac077","DOI":"10.1210\/jendso\/bvac077","article-title":"Adult Growth Hormone Deficiency: Diagnostic and Treatment Journeys From the Patients\u2019 Perspective","volume":"6","author":"Hoffman","year":"2022","journal-title":"J. Endocr. Soc."},{"key":"ref_24","first-page":"e13523","article-title":"Diabetes Insipidus: Pathogenesis, Diagnosis, and Clinical Management","volume":"13","author":"Mutter","year":"2021","journal-title":"Cureus"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"9","DOI":"10.4103\/2230-8210.172273","article-title":"Diabetes insipidus: The other diabetes","volume":"20","author":"Kalra","year":"2016","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"222","DOI":"10.3348\/kjr.2001.2.4.222","article-title":"MR imaging of central diabetes insipidus: A pictorial essay","volume":"2","author":"Shin","year":"2001","journal-title":"Korean J. Radiol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"168","DOI":"10.4103\/0974-1208.121400","article-title":"Hyperprolactinemia","volume":"6","author":"Majumdar","year":"2013","journal-title":"J. Hum. Reprod. Sci."},{"key":"ref_28","first-page":"100123","article-title":"Pituitary apoplexy after COVID-19 vaccination: A case report","volume":"25","author":"Zainordin","year":"2022","journal-title":"J. Clin. Transl. Endocrinol. Case Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/j.hest.2022.04.002","article-title":"Pituitary apoplexy following adenoviral vector-based COVID-19 vaccination","volume":"4","author":"Roncati","year":"2022","journal-title":"Brain Hemorrhages"},{"key":"ref_30","first-page":"498","article-title":"Case report: Pituitary apoplexy after COVID-19 vaccination","volume":"158","year":"2022","journal-title":"Med. Clin. (Engl. Ed.)"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Morita, S., Tsuji, T., Kishimoto, S., Uraki, S., Takeshima, K., Iwakura, H., Furuta, H., Nishi, M., Inaba, H., and Matsuoka, T.A. (2022). Isolated ACTH deficiency following immunization with the BNT162b2 SARS-CoV-2 vaccine: A case report. BMC Endocr. Disord., 22.","DOI":"10.1186\/s12902-022-01095-3"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"889074","DOI":"10.3389\/fendo.2022.889074","article-title":"Central Diabetes Insipidus Following Immunization With BNT162b2 mRNA COVID-19 Vaccine: A Case Report","volume":"13","author":"Bogalho","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.aace.2022.06.001","article-title":"A Case of Hypophysitis Associated With SARS-CoV-2 Vaccination","volume":"8","author":"Ankireddypalli","year":"2022","journal-title":"AACE Clin. Case Rep."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Ach, T., Kammoun, F., El Fekih, H., Slama, N.B.H., Kahloun, S., and Fredj, F.B. (2022). Central diabetes insipidus revealing a hypophysitis induced by SARS-CoV-2 vaccine. Therapie.","DOI":"10.1016\/j.therap.2022.09.007"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"23247096211043386","DOI":"10.1177\/23247096211043386","article-title":"A Case of Hypophysitis Following Immunization With the mRNA-1273 SARS-CoV-2 Vaccine","volume":"9","author":"Murvelashvili","year":"2021","journal-title":"J. Investig. Med. High Impact Case Rep."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1016\/j.molmed.2022.04.007","article-title":"Adverse effects of COVID-19 mRNA vaccines: The spike hypothesis","volume":"28","author":"Trougakos","year":"2022","journal-title":"Trends Mol. Med."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Cosentino, M., and Marino, F. (2022). Understanding the Pharmacology of COVID-19 mRNA Vaccines: Playing Dice with the Spike?. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms231810881"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"103553","DOI":"10.1016\/j.jddst.2022.103553","article-title":"Lipid nanoparticles in the development of mRNA vaccines for COVID-19","volume":"74","author":"Wilson","year":"2022","journal-title":"J. Drug Deliv. Sci. Technol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Tondo, G., Virgilio, E., Naldi, A., Bianchi, A., and Comi, C. (2022). Safety of COVID-19 Vaccines: Spotlight on Neurological Complications. Life, 12.","DOI":"10.3390\/life12091338"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bellamkonda, N., Lambe, U.P., Sawant, S., Nandi, S.S., Chakraborty, C., and Shukla, D. (2022). Immune Response to SARS-CoV-2 Vaccines. Biomedicines, 10.","DOI":"10.3390\/biomedicines10071464"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"198555","DOI":"10.1016\/j.virusres.2021.198555","article-title":"Inactivation of SARS-CoV-2 by \u03b2-propiolactone causes aggregation of viral particles and loss of antigenic potential","volume":"305","author":"Gupta","year":"2021","journal-title":"Virus Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"876336","DOI":"10.3389\/fpubh.2022.876336","article-title":"Vaccine Side Effects Following COVID-19 Vaccination Among the Residents of the UAE-An Observational Study","volume":"10","author":"Ganesan","year":"2022","journal-title":"Front. Public Health"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"101371","DOI":"10.1016\/j.beem.2019.101371","article-title":"Hypophysitis: An update on the novel forms, diagnosis and management of disorders of pituitary inflammation","volume":"33","author":"Gubbi","year":"2019","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1186\/s40842-016-0034-8","article-title":"Hypophysitis: Evaluation and Management","volume":"2","author":"Faje","year":"2016","journal-title":"Clin. Diabetes Endocrinol."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Ach, T., Wojewoda, P., Toullet, F., Ducloux, R., and Av\u00e9rous, V. (2020). Multiple endocrinological failures as a clinical presentation of a metastatic lung adenocarcinoma. Endocrinol. Diabetes Metab. Case Rep., 2020.","DOI":"10.1530\/EDM-20-0024"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"15257","DOI":"10.1038\/s41598-020-71988-7","article-title":"Single-institution case series of pituitary biopsy for suspected germinoma in the pediatric population: Diagnostic utility, operative risks, and biopsy approaches","volume":"10","author":"Day","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s11102-021-01181-0","article-title":"Safety of endoscopic endonasal biopsy for the pituitary stalk-hypothalamic lesions","volume":"25","author":"Kang","year":"2022","journal-title":"Pituitary"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1007\/s10067-022-06149-4","article-title":"Autoimmune post-COVID vaccine syndromes: Does the spectrum of autoimmune\/inflammatory syndrome expand?","volume":"41","author":"Jara","year":"2022","journal-title":"Clin. Rheumatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"589833","DOI":"10.3389\/fimmu.2020.589833","article-title":"Adjuvants for Coronavirus Vaccines","volume":"11","author":"Liang","year":"2020","journal-title":"Front. Immunol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Chen, P.-Y., Wu, B.-J., Su, M.-C., Lin, Y.-H., Chiang, S.-C., Wu, J.-C., Chen, T.-J., and Chen, Y.-C. (2022). Risk Factors and Incidence Rates of Self-Reported Short-Term Adverse Events of COVID-19 Vaccine Booster Dose. Vaccines, 10.","DOI":"10.3390\/vaccines10071115"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Borba, V., Malkova, A., Basantsova, N., Halpert, G., Andreoli, L., Tincani, A., Amital, H., and Shoenfeld, Y. (2020). Classical Examples of the Concept of the ASIA Syndrome. Biomolecules, 10.","DOI":"10.3390\/biom10101436"},{"key":"ref_52","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."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"64","DOI":"10.31138\/mjr.28.2.64","article-title":"The ASIA syndrome: Basic concepts","volume":"28","author":"Watad","year":"2017","journal-title":"Mediterr. J. Rheumatol."},{"key":"ref_54","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":"ref_55","doi-asserted-by":"crossref","first-page":"1620","DOI":"10.1038\/s41467-020-15562-9","article-title":"Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV","volume":"11","author":"Ou","year":"2020","journal-title":"Nat. Commun."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1038\/s42003-021-02983-5","article-title":"SARS-CoV-2 infection induces a pro-inflammatory cytokine response through cGAS-STING and NF-\u03baB","volume":"5","author":"Neufeldt","year":"2022","journal-title":"Commun. Biol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.therap.2022.03.001","article-title":"Pharmacovigilance and drug safety: Fair prescribing and clinical research","volume":"77","author":"Montastruc","year":"2022","journal-title":"Therapie"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.3892\/ol.2015.4046","article-title":"Diagnosis and management of tumor-like hypophysitis: A retrospective case series","volume":"11","author":"Guo","year":"2016","journal-title":"Oncol. Lett."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1007\/s11547-019-01120-x","article-title":"Imaging findings in hypophysitis: A review","volume":"125","author":"Caranci","year":"2020","journal-title":"La Radiol. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1766","DOI":"10.3174\/ajnr.A1714","article-title":"A radiologic score to distinguish autoimmune hypophysitis from nonsecreting pituitary adenoma preoperatively","volume":"30","author":"Gutenberg","year":"2009","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"278","DOI":"10.11604\/pamj.2017.27.278.11361","article-title":"Macroprolactinemia and Empty Sella Syndrome","volume":"27","author":"Taieb","year":"2017","journal-title":"Pan Afr. Med. J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"3460","DOI":"10.1210\/jc.2015-2146","article-title":"Treatment of Primary Hypophysitis in Germany","volume":"100","author":"Honegger","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1007\/s13244-014-0362-0","article-title":"Pituitary apoplexy: An update on clinical and imaging features","volume":"5","author":"Boellis","year":"2014","journal-title":"Insights Into Imaging"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.1016\/S0140-6736(21)00628-0","article-title":"Efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine against SARS-CoV-2 variant of concern 202012\/01 (B.1.1.7): An exploratory analysis of a randomised controlled trial","volume":"397","author":"Emary","year":"2021","journal-title":"Lancet"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1056\/NEJMoa2104840","article-title":"Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination","volume":"384","author":"Greinacher","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_66","first-page":"e11","article-title":"Thrombotic Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination","volume":"385","author":"Lai","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"4228","DOI":"10.1182\/bloodadvances.2022007766","article-title":"The clinical and laboratory diagnosis of vaccine-induced immune thrombotic thrombocytopenia","volume":"6","author":"Bissola","year":"2022","journal-title":"Blood Adv."},{"key":"ref_68","first-page":"e11","article-title":"Pituitary apoplexy and COVID-19 vaccination","volume":"159","author":"Mungmunpuntipantip","year":"2022","journal-title":"Med. Clin. (Engl. Ed.)"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.molmed.2022.03.009","article-title":"Trained immunity-related vaccines: Innate immune memory and heterologous protection against infections","volume":"28","author":"Ziogas","year":"2022","journal-title":"Trends Mol. Med."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"110951","DOI":"10.1016\/j.mehy.2022.110951","article-title":"Increased intracranial pressure due to chronic weight lifting exercises as a hypothesis of partial empty sella syndrome in an elite athlete","volume":"167","author":"Taieb","year":"2022","journal-title":"Med. Hypotheses"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1590\/2359-3997000000047","article-title":"Pituitary apoplexy: Pathophysiology, diagnosis and management","volume":"59","author":"Glezer","year":"2015","journal-title":"Arch. Endocrinol. Metab."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1210\/er.2015-1042","article-title":"Pituitary Apoplexy","volume":"36","author":"Briet","year":"2015","journal-title":"Endocr. Rev."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Biagetti, B., and Sim\u00f2, R. (2022). Pituitary Apoplexy: Risk Factors and Underlying Molecular Mechanisms. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23158721"},{"key":"ref_74","first-page":"502","article-title":"A conservative management is preferable in milder forms of pituitary tumor apoplexy","volume":"34","author":"Leyer","year":"2011","journal-title":"J. Endocrinol. Investig."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"219","DOI":"10.21037\/qims.2018.03.08","article-title":"Clinical and imaging features of pituitary apoplexy and role of imaging in differentiation of clinical mimics","volume":"8","author":"Goyal","year":"2018","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"7951536","DOI":"10.1155\/2016\/7951536","article-title":"Multidisciplinary Management of Pituitary Apoplexy","volume":"2016","author":"Albani","year":"2016","journal-title":"Int. J. Endocrinol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/00004728-199001000-00007","article-title":"Subacute pituitary apoplexy: MR and CT appearance","volume":"14","author":"Kyle","year":"1990","journal-title":"J. Comput. Assist. Tomogr."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1080\/09513590.2021.1938527","article-title":"Pituitary apoplexy of a giant prolactinoma during pregnancy","volume":"37","author":"Khaldi","year":"2021","journal-title":"Gynecol. Endocrinol. Off. J. Int. Soc. Gynecol. Endocrinol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"e988","DOI":"10.1016\/j.wneu.2019.07.055","article-title":"Pituitary Apoplexy: Results of Surgical and Conservative Management Clinical Series and Review of the Literature","volume":"130","author":"Almeida","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.2147\/CIA.S181109","article-title":"Conservative treatment cures an elderly pituitary apoplexy patient with oculomotor paralysis and optic nerve compression: A case report and systematic review of the literature","volume":"13","author":"Fan","year":"2018","journal-title":"Clin. Interv. Aging"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00701-009-0595-8","article-title":"Pituitary apoplexy: An overview of 186 cases published during the last century","volume":"152","author":"Turgut","year":"2010","journal-title":"Acta Neurochir."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1053\/j.seminhematol.2022.03.002","article-title":"Treatment of vaccine-induced immune thrombotic thrombocytopenia (VITT)","volume":"59","author":"Gabarin","year":"2022","journal-title":"Semin. Hematol."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Singh, B., Kanack, A., Bayas, A., George, G., Abou-Ismail, M.Y., Kohlhagen, M., Christ, M., Naumann, M., Moser, K., and Smock, K. (2021). Anti-PF4 VITT antibodies are oligoclonal and variably inhibited by heparin. Medrxiv Prepr. Serv. Health Sci.","DOI":"10.1101\/2021.09.23.21263047"}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/10\/12\/2004\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:26:09Z","timestamp":1760145969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/10\/12\/2004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,24]]},"references-count":83,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["vaccines10122004"],"URL":"https:\/\/doi.org\/10.3390\/vaccines10122004","relation":{},"ISSN":["2076-393X"],"issn-type":[{"type":"electronic","value":"2076-393X"}],"subject":[],"published":{"date-parts":[[2022,11,24]]}}}