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.
【저자키워드】 SARS-CoV-2, Vaccine, Graves' disease, Type 1 diabetes mellitus, 【초록키워드】 Vaccine, coronavirus, Diseases, Pathogenesis, adjuvants, Viral proteins, diabetes, severe acute respiratory syndrome Coronavirus, immune, SARS-CoV-2 vaccine, type 2 diabetes, BNT162b2, mRNA, clinical, Fever, environmental exposure, Patient, adjuvant, Autoimmune, molecular, molecular mimicry, respiratory, Autoimmune diseases, disease, Pfizer-BioNTech, mechanism, Graves' disease, Type 1 diabetes mellitus, administration, Genetic predisposition, Trigger, triggers, asthenia, weight loss, acute respiratory syndrome, Viral protein, biochemical, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, thyrotoxicosis, syndrome, disorder, grave, thought, Occurrence, develop, occurred, explained, demonstrated, autoimmune diabete, endocrine disease, Type 1 diabete, 【제목키워드】 Diabetes Mellitus, disease, SARS-CoV-2 vaccination, Graves' disease, grave,