Graves Disease
Conditions
Brief summary
It is well known that an infection can be a triggering factor for the development of autoimmune thyroid disease. The COVID-19 pandemic was an example of this, with several reports of both subacute thyroiditis as well as Graves' disease occurring after experiencing SARS-CoV-2 disease. There have also been cases of Graves' disease reported after COVID-19 vaccination administration (\<4 weeks between the vaccine and the development of hyperthyroidism). However, the current evidence is of low quality and consists mainly of case reports. A search strategy on October 3, 2022, in the medical database PubMed could only retain one retrospective study on this subject. In this study by di Filippo et al., approximately 64 new cases of Graves' disease with hyperthyroidism were identified in the Milan region, Italy, in the year 2021, of which 20 patients had an onset within 4 weeks following COVID vaccine administration (31.2%). The investigators would like to increase the knowledge about the possible link between COVID-19 (both the disease and the vaccination) and Graves' disease, by means of a case-control analysis of all 'de novo' cases of Graves' hyperthyroidism described in the C.H.U. Brugmann. The investigators want to investigate whether Graves' disease after vaccination would be clinically different from the classic Graves' disease, thereby describing factors such as the duration of the disease, the level of thyroid-stimulating immunoglobulins (TSI), the percentage of T3-dominant Graves' disease, or the dose of thyreostatics (such as strumazole) required to control the disease.
Interventions
OTHERData extraction
Data extraction from medical records
Sponsors
Laura ICONARU
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All patients who developed 'de novo' Graves' disease between March 2020 (the beginning of the COVID-19 epidemic in Belgium) and October 2022.
Exclusion criteria
* Pregnancy * Pre-existing Graves' disease (before March 2020) * Diagnosis of other thyroid disease, such as subacute or painless destructive thyroiditis * Use of thyroid-interfering drugs, such as lithium, amiodarone or immune checkpoint inhibitor therapy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| TSI levels | 2 years | Blood levels of thyroid-stimulating immunoglobulin (thyroid autoantibodies) |
| Anti-thyroperoxidase levels | 2 years | Thyroid autoantibodies levels (thyroid autoantibodies) |
| Anti-thyroglobulin levels | 2 years | Thyroid autoantibodies levels (thyroid autoantibodies) |
| Conclusions of the Thyroid ultrasound examination | 2 years | — |
| Conclusions of the Thyroid scintigraphy examination | 2 years | — |
| Anti-thyroid treatment | 2 years | Narrative description of anti-thyroid treatments, if any |
| Demographic data | 2 years | Age, gender and smoking |
| COVID-19 infection (yes/no) | 2 years | Evidence for COVID-19 infection, based on emergency room consultation, hospitalization for COVID-19, positive PCR testing or CT scan |
| COVID-19 vaccination status | 2 years | Timing, type and dosing of COVID-19 vaccine administration |
| TSH levels | 2 years | Blood levels of thyroid-stimulating hormone (Thyroid hormone) |
| Free thyroxine levels | 2 years | Free thyroxine blood levels (Thyroid hormone) |
| Free T3 levels | 2 years | Free T3 blood levels (Thyroid hormone) |
Countries
Belgium
Outcome results
None listed