A Case of Hypophysitis Associated With SARS-CoV-2 Vaccination.
A Case of Hypophysitis Associated With SARS-CoV-2 Vaccination.
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DOI：
10.1016/j.aace.2022.06.001
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发表时间：
2022-09
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虽然SARS-CoV-2疫苗已经用多种新技术开发出来，并在全球范围内迅速传播，但其不良反应的完整情况尚不清楚。最近，有零星的，但越来越多的报告与SARS-CoV-2疫苗接种的内分泌疾病。在这里，我们报告了一例罕见的垂体炎急性发作的尿崩症，立即接种SARS-CoV-2疫苗后。一名48岁的女性患者在接种第一支SARS-CoV-2疫苗之前一直处于正常健康状态。接种疫苗后两天，她开始出现流感样症状，包括严重头痛和肌痛以及持续头痛、烦渴和多尿。她被诊断为尿崩症，磁共振成像显示垂体柄增厚。接种疫苗3个月后，她的症状有所改善，但磁共振成像仍显示垂体柄增厚。鉴于尿崩症发生的时间，我们认为患者的垂体炎可能与SARS-CoV-2疫苗接种有关。我们还通过文献检索发现了19例SARS-CoV-2疫苗接种后发生内分泌疾病的病例。报告的内分泌器官为甲状腺、垂体和肾上腺。还报告了12例糖尿病病例。在3例垂体病例中，尿崩症仅见于我们的病例。我们报告一例罕见的SARS-CoV-2疫苗引发的垂体炎，导致尿崩症。SARS-CoV-2疫苗相关的内分泌疾病似乎确实是可能的。内分泌病与罕见的并发症有关;然而，在SARS-CoV-2疫苗接种后的人群中，它可能被低估。进一步的研究是必要的，以更好地了解SARS-CoV-2疫苗相关的内分泌疾病。
Although SARS-CoV-2 vaccines have been developed with multiple novel technologies and rapidly disseminated worldwide, the full profile of adverse effects has not been known. Recently, there are sporadic but increasing reports of endocrinopathy in relation to SARS-CoV-2 vaccination. Here we report a rare case of hypophysitis with acute onset of diabetes insipidus, immediately after SARS-CoV-2 vaccination. A 48-year-old female patient had been in her usual state of health until she received the first SARS-CoV-2 vaccine. Two days after vaccination, she started to have flu-like symptoms, including severe headache and myalgia as well as persistent headache, polydipsia, and polyuria. She was diagnosed with diabetes insipidus, and magnetic resonance imaging revealed thickening of the pituitary stalk. Three months after vaccination, her symptoms had somewhat improved, but she still had pituitary stalk thickening on magnetic resonance imaging. Given the timing of the occurrence of diabetes insipidus, we believe that the patient’s hypophysitis may be associated with SARS-CoV-2 vaccination. We also found 19 cases of endocrinopathy after SARS-CoV-2 vaccination by literature search. The reported endocrine organs were the thyroid, pituitary, and adrenals. Twelve cases of diabetes were also reported. Among 3 pituitary cases, diabetes insipidus was reported only in our case. We report a rare case of SARS-CoV-2 vaccine-triggered hypophysitis, which led to diabetes insipidus. SARS-CoV-2 vaccine–related endocrinopathy seems, indeed, possible. Endocrinopathy is associated with infrequent complications; however, it may be underestimated in the post–SARS-CoV-2-vaccinated population. Further studies are warranted to better understand SARS-CoV-2 vaccine–related endocrinopathy.