Two cases of Graves' disease following SARS-CoV-2 vaccination: An autoimmune/inflammatory syndrome induced by adjuvants.

Background: The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) comprises four entities, including the post-vaccination phenomenon, which appears after being exposed to adjuvants in vaccines that increase the immune response. There is limited information about autoimmune endocrine diseases and ASIA following SARS-CoV-2 vaccination. Patient's findings: Two female healthcare workers received a SARS-CoV-2 vaccine, and 3 days later, developed clinical manifestations of thyroid hyperactivity, with an increase thyroid hormone levels on thyroid function tests, suppressed thyroid-stimulating hormone, and elevated anti-thyroid-antibodies. Summary: Vaccines have been shown to trigger an immune response that leads to a broad spectrum of autoimmune diseases, including autoimmune thyroid disease. Our patients met the diagnostic criteria for ASIA; they were exposed to an adjuvant (vaccine), and they developed clinical manifestations of thyroid hyperfunction within a few days, with the appearance of anti-thyroid antibodies, despite being healthy prior to vaccination. Conclusion: Graves' disease can occur following SARS-CoV-2 vaccination.