Pituitary and COVID-19 vaccination: a systematic review.

IF 3.3 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Martina Verrienti, Valentino Marino Picciola, Maria Rosaria Ambrosio, Maria Chiara Zatelli
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引用次数: 0

Abstract

Purpose: This systematic review aims to examine the latest research findings and assess the impact of COVID-19 vaccination on the pituitary gland.

Method: PubMed and Tripdatabase were searched from January 1st, 2020 to February 12th, 2024. Case reports, case series and reviews related to post COVID-19 vaccination pituitary disease were included. Eligible articles were tabulated and analysed in the attempt to provide an overview on the epidemiology, clinical presentation, imaging, treatment, outcomes and pathophysiological background of post COVID-19 vaccination pituitary disease.

Results: Among the 23 case reports included in this review, post COVID-19 vaccination hypophysitis was reported in 9 patients, pituitary apoplexy (PA) in 6 cases, SIADH in 5 cases and Isolated ACTH deficiency in 2 cases. Additionally, precipitating adrenal crisis was registered in 7 patients and pituitary tumor enlargement in 1 patient after receiving COVID-19 vaccination.

Conclusion: Despite the rarity of these events, our research findings suggest an association between COVID-19 vaccination and the subsequent development of pituitary diseases. The most common manifestations include hypophysitis with ADH deficiency, PA and SIADH, with symptoms typically emerging shortly after vaccine administration. Potential pathogenetic mechanisms include molecular mimicry, vaccine adjuvants and vaccine-induced thrombotic thrombocytopenia (VITT), with the presence of ACE2 receptors in the hypothalamus-pituitary system contributing to the process. These findings can aid in diagnostic and treatment decisions for patients presenting with these syndromes. Nevertheless, given the rarity of these events, safety and efficacy of the currently available COVID-19 vaccines remain robust and we strongly advocate continuing pursuing vaccination efforts.

Abstract Image

脑垂体与 COVID-19 疫苗接种:系统综述。
目的:本系统综述旨在研究最新的研究成果,评估接种 COVID-19 疫苗对垂体的影响:方法:检索 2020 年 1 月 1 日至 2024 年 2 月 12 日期间的 PubMed 和 Tripdatabase。纳入了与接种 COVID-19 疫苗后垂体疾病相关的病例报告、系列病例和综述。对符合条件的文章进行了制表和分析,试图概述 COVID-19 疫苗接种后垂体疾病的流行病学、临床表现、影像学、治疗、结果和病理生理背景:结果:在本综述收录的 23 例病例报告中,9 例为 COVID-19 疫苗接种后垂体功能减退症,6 例为垂体性脑瘫(PA),5 例为 SIADH,2 例为孤立性促肾上腺皮质激素(ACTH)缺乏症。此外,7 例患者在接种 COVID-19 疫苗后出现肾上腺危象,1 例患者出现垂体瘤增大:结论:尽管这些事件很少发生,但我们的研究结果表明,接种 COVID-19 疫苗与随后发生垂体疾病之间存在关联。最常见的表现包括伴有 ADH 缺乏的垂体功能减退症、PA 和 SIADH,症状通常在接种疫苗后不久出现。潜在的致病机制包括分子模拟、疫苗佐剂和疫苗诱导的血栓性血小板减少症(VITT),而下丘脑-垂体系统中 ACE2 受体的存在有助于这一过程。这些发现有助于对出现这些综合征的患者做出诊断和治疗决定。尽管如此,鉴于这些事件的罕见性,目前可用的 COVID-19 疫苗的安全性和有效性仍然很高,我们强烈建议继续开展疫苗接种工作。
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来源期刊
Pituitary
Pituitary 医学-内分泌学与代谢
CiteScore
7.10
自引率
7.90%
发文量
90
审稿时长
6 months
期刊介绍: Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.
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