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谢倩, 牟鈃雨, 李双庆. 人乳头瘤病毒疫苗接种后亚急性甲状腺炎1例报告[J]. 四川大学学报(医学版), 2021, 52(6): 1047-1048. DOI: 10.12182/20211160506
引用本文: 谢倩, 牟鈃雨, 李双庆. 人乳头瘤病毒疫苗接种后亚急性甲状腺炎1例报告[J]. 四川大学学报(医学版), 2021, 52(6): 1047-1048. DOI: 10.12182/20211160506
XIE Qian, MU Xing-yu, LI Shuang-qing. Subacute Thyroiditis Following HPV Vaccination: A Case Report[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(6): 1047-1048. DOI: 10.12182/20211160506
Citation: XIE Qian, MU Xing-yu, LI Shuang-qing. Subacute Thyroiditis Following HPV Vaccination: A Case Report[J]. Journal of Sichuan University (Medical Sciences), 2021, 52(6): 1047-1048. DOI: 10.12182/20211160506

人乳头瘤病毒疫苗接种后亚急性甲状腺炎1例报告

Subacute Thyroiditis Following HPV Vaccination: A Case Report

  • 摘要: 亚急性甲状腺炎(SAT)是最常见的自限性甲状腺疼痛疾病,病因尚不明确,多与病毒感染或病毒感染后的变态反应有关,疫苗接种后出现SAT极为罕见。本例患者接种第1剂九价人乳头瘤病毒疫苗(Gardasil 9)0.5 mL约8 h后无明确诱因出现发热,最高体温37.8 ℃,伴颈部疼痛、疲惫乏力,吞咽时疼痛加剧,入院后查体发现甲状腺Ⅱ°肿大,质硬,触痛明显,未闻及血管杂音,疫苗接种处无红肿、破溃,余查体未见明显异常,实验室检查:C-反应蛋白25.20 mg/L,血沉55 mm/1 h,白细胞4.94×109 L−1,促甲状腺激素0.137 mU/L,游离甲状腺素22.32 pmol/L,抗甲状腺球蛋白抗体69.18 IU/mL,抗甲状腺过氧化物酶抗体21.66 IU/mL。甲状腺彩超示:双侧甲状腺弥漫性肿大,内回声不均。诊断为SAT。予以布洛芬对症治疗,经治疗5 d后患者未再出现低热,颈部疼痛症状缓解。随访至今,已完成3剂九价人乳头瘤病毒疫苗的接种,复查甲状腺功能正常,未见SAT复发。

     

    Abstract: Subacute thyroiditis (SAT) is the most common self-limiting thyroid disease causing pain. The etiology of the disease remains unknown, but it is usually related to viral infection or allergic reaction after viral infection. SAT after vaccination is extremely rare. The patient had a fever of no clearly defined cause about 8 hours after receiving the first dose of a 0.5 mL 9-valent human papillomavirus vaccine (Gardasil 9). The highest temperature was 37.8 ℃, accompanied by a pain in the neck, fatigue and the increasing pain when swallowing. After the patient was admitted to the hospital, physical examination revealed Ⅱ° enlargement of the thyroid gland, which was hard and tender, and no vascular murmur was heard. There was no redness, swelling or ulceration at the vaccination site, and no obvious abnormalities were observed in other physical examinations. Laboratory findings were as follows: C-reactive protein, 25.20 mg/L; erythrocyte sedimentation rate, 55 mm/1 h; leukocyte, 4.94×109 L−1; thyrotropin, 0.137 mU/L; free thyroxine, 22.32 pmol/L; antithyroglobulin antibody, 69.18 IU/mL; anti-thyroid peroxidase antibody, 21.66 IU/mL. Thyroid ultrasonography showed diffuse enlargement of bilateral thyroid with uneven internal echo. The patient was diagnosed with SAT. After 5 days of treatment with ibuprofen, the patient no longer had low fever and the neck pain was relieved. The patient was followed up till now, and had completed the vaccination of the three-dose 9-valent human papillomavirus vaccine. The function of thyroid was found to be normal in follow-up visits, and SAT did not recur.

     

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