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Case Reports
. 2021 Dec:125:102738.
doi: 10.1016/j.jaut.2021.102738. Epub 2021 Oct 12.

A case of Graves' disease and type 1 diabetes mellitus following SARS-CoV-2 vaccination

Armando Patrizio  1 , Silvia Martina Ferrari  2 , Alessandro Antonelli  3 , Poupak Fallahi  4
Affiliations
Case Reports

A case of Graves' disease and type 1 diabetes mellitus following SARS-CoV-2 vaccination

Armando Patrizio et al. J Autoimmun. 2021 Dec.

Abstract

Autoimmune diseases, including autoimmune endocrine diseases (AIED), are thought to develop following environmental exposure in patients with genetic predisposition. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and vaccines against it could represent new environmental triggers for AIED. We report a patient, with history of vitiligo vulgaris and 8 years of type 2 diabetes, who came to our institution because of fever, weight loss, asthenia and thyrotoxicosis occurred 4 weeks later the administration of BNT162B2 (Pfizer-BioNTech) SARS-CoV-2 vaccine. Clinical, biochemical and instrumental work-up demonstrated Graves' disease and autoimmune diabetes mellitus. The occurrence of these disorders could be explained through different mechanism such as autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome), mRNA "self-adjuvant" effect, molecular mimicry between human and viral proteins and immune disruption from external stimuli. However further studies are needed to better understand the underlying pathogenesis of AIED following SARS-CoV-2 vaccine.

Keywords: Graves' disease; SARS-CoV-2; Type 1 diabetes mellitus; Vaccine.

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