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Cláudia C.D. Nakabashi Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil

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Teresa S. Kasamatsu Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo

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Felipe Crispim Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo

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Claudia A. Yamazaki Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo

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Cléber P. Camacho Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Danielle M. Andreoni Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Rosalia P. Padovani Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Elza S. Ikejiri Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Maria C.O.M. Mamone Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Flávia C. Aldighieri Fleury Medicina e Saúde, São Paulo, Brazil

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Jairo Wagner Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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Jairo T. Hidal Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil

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José G.H. Vieira Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Fleury Medicina e Saúde, São Paulo, Brazil

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Rosa P.M. Biscolla Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil

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Rui M.B. Maciel Laboratory of Molecular and Translational Endocrinology, Division of Endocrinology, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo
Thyroid Diseases Center, Instituto Israelita de Ensino e Pesquisa Albert Einstein, São Paulo, Brazil
Fleury Medicina e Saúde, São Paulo, Brazil

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histopathology descriptions or according to cervical ultrasound (US) 3-4 months after surgery. Also, 27 of 147 patients had received more than one 131 I treatment (total of 250-600 mCi) for the treatment of recurrent local disease or lymph node metastases that

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Marco Marino Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Center for Genomic Research, Italy

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Maria Laura Monzani Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Giulia Brigante Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Katia Cioni Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Bruno Madeo Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Daniele Santi Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Antonino Maiorana Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Italy

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Stefania Bettelli Department of Diagnostic and Clinical Medicine and Public Health, University of Modena and Reggio Emilia, Italy

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Valeria Moriondo Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Center for Genomic Research, Italy

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Elisa Pignatti Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Center for Genomic Research, Italy

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Lara Bonacini Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Cesare Carani Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy

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Vincenzo Rochira Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Azienda USL of Modena, Modena, Italy

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Manuela Simoni Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, Italy
Center for Genomic Research, Italy
Azienda USL of Modena, Modena, Italy

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considered a diagnostic marker of PTC [ 1 ]. The wide clinical use of ultrasound (US) [ 5 ] allows detecting an increasing number of nodules that often require fine needle aspiration biopsy (FNAB) for ruling out thyroid cancer [ 6 ]. As the diagnostic value

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Santiago Tofé Department of Endocrinology, University Hospital Son Espases, Palma de Mallorca, Spain

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Iñaki Argüelles Department of Endocrinology, University Hospital Son Espases, Palma de Mallorca, Spain

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Ana Forteza Department of Pathology, University Hospital Son Espases, Palma de Mallorca, Spain

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Cristina Álvarez Department of Surgery, Section of Endocrine Surgery, University Hospital Son Espases, Palma de Mallorca, Spain

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Alessandra Repetto Department of Nuclear Medicine, University Hospital Son Espases, Palma de Mallorca, Spain

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Luis Masmiquel Department of Endocrinology, University Hospital Son Llatzer, Palma de Mallorca, Spain

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Irene Rodríguez Department of Endocrinology, University Hospital Son Llatzer, Palma de Mallorca, Spain

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Eladio Losada Department of Endocrinology, Hospital Can Misses, Ibiza, Spain

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Nuria Sukunza Department of Endocrinology, Hospital de Manacor, Manacor, Spain

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María Cabrer Department of Endocrinology, Hospital Comarcal de Inca, Inca, Spain

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Mildred Sifontes Department of Pathology, Hospital Mateu Orfila, Menorca, Spain

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María del Mar del Barrio Department of Pathology, Hospital Mateu Orfila, Menorca, Spain

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Antonia Barceló Department of Laboratory, University Hospital Son Espases, Palma de Mallorca, Spain

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Álvaro Tofé Department of Maxillofacial Surgery, Hospital Puerta del Mar, Cádiz, Spain

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Vicente Pereg Department of Endocrinology, University Hospital Son Espases, Palma de Mallorca, Spain

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-specific MRs in this large cohort of patients with TC. Finally, we have performed an additional analysis to explore the role of changes in the routine management of thyroid nodular disease, that is, performance of neck ultrasound (US) and fine-needle aspiration

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George J. Kahaly Department of Medicine I, Johannes Gutenberg University (JGU) Medical Center, Mainz, Germany

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Luigi Bartalena Department of Medicine and Surgery, University of Insubria, Varese, Italy

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Lazlo Hegedüs Department of Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark

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Laurence Leenhardt Thyroid and Endocrine Tumors Unit, Pitié Salpêtrière Hospital, Sorbonne University, Paris, France

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Kris Poppe Endocrine Unit, CHU Saint-Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Simon H. Pearce Department of Endocrinology, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom

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manifestations. 2, ∅∅∅○ Imaging Considerable inter- and intraregional variation in diagnostic practice has been reported for GD [ 22 ]. In addition to thyroid function and TSH-R-Ab determination, most clinicians would request thyroid ultrasound (US) and

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Ringo Manta Department of Nuclear Medicine, CHU Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Charlotte Martin Department of Infectious Diseases, CHU Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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Vinciane Muls Department of Gastroenterology and Endoscopy, CHU Saint-Pierre, University Libre de Bruxelles (ULB), Brussels, Belgium

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Kris G Poppe Department of Endocrinology, CHU Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium

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A 22-year-old male with a history of ulcerative colitis and nephrotic syndrome treated with immunomodulatory agents including vedolizumab and mycophenolic acid developed hyperthyroidism 2 weeks following the first administration of BNT162b2 vaccine (Pfizer-BioNTech COVID-19 vaccine). Graves’ disease (GD) was diagnosed based on the elevated thyrotropin-receptor antibody, thyroid scintigraphy and ultrasound. To this day, four cases of new-onset GD following SARS-CoV-2 vaccine were reported in patients with no previous history of thyroid disease. Two cases of recurrence of GD following SARS-CoV-2 vaccine were also reported. Although the underlying mechanisms of vaccine-induced autoimmunity remain to be clarified, there is a rationale for the association between SARS-CoV-2 vaccination and the development of Th1-mediated diseases, at least in predisposed individuals. The BNT162b2 vaccine could be a trigger for GD in some patients. However, the benefit/risk ratio remains by far in favour of SARS-CoV-2 vaccination considering the potentially higher risk of severe infection in these patients.

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Lei Xu Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China
Xi’an Hospital of Traditional Chinese Medicine, Xi’an, China

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Junling Gao Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China

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Quan Wang Laboratory of Surgical Oncology, Peking University People’s Hospital, Peking University, Beijing, China

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Jichao Yin Xi’an Hospital of Traditional Chinese Medicine, Xi’an, China

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Pengfei Yu Xijing Hospital, Fourth Military Medical University, Xi’an, China

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Bin Bai Xijing Hospital, Fourth Military Medical University, Xi’an, China

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Ruixia Pei Xi’an Hospital of Traditional Chinese Medicine, Xi’an, China

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Dingzhang Chen Xijing Hospital, Fourth Military Medical University, Xi’an, China

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Guochun Yang Xi’an Hospital of Traditional Chinese Medicine, Xi’an, China

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Shiqi Wang Xijing Hospital, Fourth Military Medical University, Xi’an, China

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Mingxi Wan Key Laboratory of Biomedical Information Engineering of the Ministry of Education, Department of Biomedical Engineering, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China

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–15% are determined to be malignant [ 4 - 6 ]. Ultrasound is the first-line method for identifying malignant thyroid nodules [ 3 ], but the diagnostic performance of ultrasound relies heavily on the clinical experience of the radiologists. To improve the

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Furio Pacini Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy

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considerations: first, the indolent biological course of lymph node metastases, and, second, the low detection rate of lymph node metastases in the 1970s. At that time, neither neck ultrasound (US) nor serum thyroglobulin (Tg) measurements were available in

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Aly Bernard Khalil Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Roberto Dina Hammersmith Hospital, London, United Kingdom

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Karim Meeran Hammersmith Hospital, London, United Kingdom

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Ali M. Bakir Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Saf Naqvi Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Alia Al Tikritti Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Nader Lessan Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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Maha T. Barakat Imperial College London Diabetes Center, Abu Dhabi, United Arab Emirates

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the primary diagnostic tool for determining the nature of a thyroid nodule. Its yield increases if done under ultrasound guidance [ 2 - 7 ]. However, it fails to provide a conclusive result in a subset of patients, labeled as having an “indeterminate

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Rachelle P Mendoza Department of Pathology, University of Rochester Medical Center, Rochester, New York, USA

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Richard Cody Simon Department of Pathology, University of Chicago, Chicago, Illinois, USA

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Nicole A Cipriani Department of Pathology, University of Chicago, Chicago, Illinois, USA

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Tatjana Antic Department of Pathology, University of Chicago, Chicago, Illinois, USA

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thyroid nodules. Clinical practices have ranged from ultrasound monitoring to repeat FNA. Flanagan et al. studied 70 patients with two or more repeat FNA after an initial benign result and then subsequently underwent surgical management ( 5 ). The repeat

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Thomas Szabo Yamashita Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Fady J. Baky Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Travis J. McKenzie Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Geoffrey B. Thompson Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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David R. Farley Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Melanie L. Lyden Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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Benzon M. Dy Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA

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breast, uterine, and thyroid cancers as well as renal ultrasound and colonoscopy. Thyroid ultrasound should begin at the age of 18 years and be repeated annually [ 4 , 5 ]. Increased adherence to these screening guidelines has resulted in increased

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