{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T20:59:50Z","timestamp":1790629190021,"version":"4.1.0"},"reference-count":37,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"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>COVID-19, a contagious disease caused by the novel coronavirus SARS-CoV-2, emerged in 2019 and quickly became a pandemic, infecting more than 700 million people worldwide. The disease incidence, morbidity and mortality rates have started to decline since the development of effective vaccines against the virus and the widespread immunization of the population. SARS-CoV-2 vaccines are associated with minor local or systemic adverse reactions, while serious adverse effects are rare. Thyroid-related disorders have been reported after vaccination for COVID-19, and Graves\u2019 disease (GD) is the second most common amongst them. Thyroid eye disease (TED), an extrathyroidal manifestation of GD, is rarely observed post-COVID-19 vaccination. All TED cases followed mRNA-based vaccinations, but two new onset mild TED cases post-viral vector vaccine (ChAdox1nCoV-19) have also been reported. We report the case of a 63-year-old woman who presented with new onset hyperthyroidism and moderate-to-severe and active TED 10 days after she received the first dose of a viral vector vaccine against SARS-CoV-2. This is the first case of moderate-to-severe TED after such a vaccine. Our patient was initially treated with intravenous glucocorticoids, and subsequently with intravenous rituximab, due to no response. The disease was rendered inactive after rituximab, but constant diplopia persisted, and the patient was referred for rehabilitative surgery.<\/jats:p>","DOI":"10.3390\/vaccines11101574","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T03:24:55Z","timestamp":1696908295000},"page":"1574","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Thyroid Eye Disease as Initial Manifestation of Graves\u2019 Disease Following Viral Vector SARS-CoV-2 Vaccine: Report of a Case and Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"given":"Anastasia K.","family":"Armeni","sequence":"first","affiliation":[{"name":"Division of Endocrinology\u2014Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1519-3776","authenticated-orcid":false,"given":"Georgios \u039a.","family":"Markantes","sequence":"additional","affiliation":[{"name":"Division of Endocrinology\u2014Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Stathopoulou","sequence":"additional","affiliation":[{"name":"Division of Endocrinology\u2014Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Saltiki","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Department of Clinical Therapeutics, National and Kapodistrian University, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Zampakis","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Hospital of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6901-3681","authenticated-orcid":false,"given":"Stelios F.","family":"Assimakopoulos","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases\u2014Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2073-8523","authenticated-orcid":false,"given":"Marina A.","family":"Michalaki","sequence":"additional","affiliation":[{"name":"Division of Endocrinology\u2014Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.1002\/jmv.27661","article-title":"Novel statistics predict the COVID-19 pandemic could terminate in 2022","volume":"94","author":"Chen","year":"2022","journal-title":"J. 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