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Le Quang M, Solé G, Martin-Négrier ML, Mathis S. Clinical and pathological aspects of toxic myopathies. J Neurol 2024; 271:5722-5745. [PMID: 38907023 DOI: 10.1007/s00415-024-12522-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/23/2024]
Abstract
As the most frequent cause of acquired myopathy, toxic myopathies are characterised by clinicopathological features that vary depending on the mode of action of the drugs or toxins involved. Although a large number of substances can induce myotoxicity, the main culprits are statins, alcohol, and corticosteroids. A rigorous, well-organised diagnostic approach is necessary to obtain a rapid diagnosis. For early diagnosis and management, it is important for clinicians to be aware that most toxic myopathies are potentially reversible, and the goal of treatment should be to avoid serious muscle damage.
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Affiliation(s)
- Mégane Le Quang
- Department of Pathology, University Hospital (CHU) of Bordeaux, Pellegrin Hospital, Place Amélie Raba Léon, 33000, Bordeaux, France
| | - Guilhem Solé
- Department of Neurology, Nerve-Muscle Unit, AOC Reference for Neuromuscular Disorders, University Hospital (CHU) of Bordeaux, Pellegrin Hospital, Place Amélie Raba Léon, 33000, Bordeaux, France
| | - Marie-Laure Martin-Négrier
- Department of Pathology, University Hospital (CHU) of Bordeaux, Pellegrin Hospital, Place Amélie Raba Léon, 33000, Bordeaux, France
| | - Stéphane Mathis
- Department of Neurology, Nerve-Muscle Unit, AOC Reference for Neuromuscular Disorders, University Hospital (CHU) of Bordeaux, Pellegrin Hospital, Place Amélie Raba Léon, 33000, Bordeaux, France.
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2
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David P, Santos GDM, Patt YS, Orsi FA, Shoenfeld Y. Immune thrombocytopenia (ITP) - could it be part of autoimmune/inflammatory syndrome induced by adjuvants (ASIA)? Autoimmun Rev 2024; 23:103605. [PMID: 39182594 DOI: 10.1016/j.autrev.2024.103605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 05/30/2024] [Indexed: 08/27/2024]
Abstract
Immune thrombocytopenia (ITP) is a complex autoimmune disorder characterized by thrombocytopenia and an increased bleeding risk, arising from autoantibody-mediated platelet destruction and impaired megakaryocyte function. The pathogenesis of ITP involves a multifaceted interplay of genetic predispositions, immune dysregulation, and environmental triggers, though the precise mechanisms remain uncertain. Several infectious agents, mostly viruses, have been implicated in both acute and chronic ITP through mechanisms such as molecular mimicry, direct bone marrow suppression, and immune dysregulation. Vaccinations, particularly those containing adjuvants like aluminum and those capable of inducing molecular mimicry, have also been associated with ITP, either as a new onset or as a relapse in preexisting cases. The role of drugs, particularly quinine, quinidine and certain antibiotics, in inducing ITP through various immunological pathways further illustrates the diverse etiologies of this condition. The multiple triggers of the disease raise the question of whether ITP may be classified as an autoimmune/inflammatory syndrome induced by adjuvants (ASIA). This condition encompasses a range of autoimmune and inflammatory symptoms triggered by adjuvants, such as silicones, polypropylene meshes, metal implants, and mineral oils present in various medical materials and medications. Similar to that observed in some cases of ITP, adjuvants can trigger autoimmune or autoinflammatory responses via molecular mimicry, epitope spreading, and polyclonal activation. This narrative review explores the underlying environmental factors related to ITP and examines ITP triggers that could potentially support an association between ITP and ASIA syndrome.
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Affiliation(s)
- Paula David
- Internal Medicine B, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Leeds Institute of Rheumatic and Musculoskeletal Diseases (LIRMM), University of Leeds, Leeds, UK.
| | - Gabrielle de Mello Santos
- Hospital das Clinicas of University of São Paulo Medical School (HCFMUSP), São Paulo, Brazil; HEMORIO - State Institute of Hematology "Arthur de Siqueira Cavalcanti", Rio de Janeiro, Brazil
| | - Yonatan Shneor Patt
- Internal Medicine B, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Fernanda A Orsi
- Hospital das Clinicas of University of São Paulo Medical School (HCFMUSP), São Paulo, Brazil; Department of Pathology, School of Medical Sciences of the University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Yehuda Shoenfeld
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Reichman University, Herzliya, Israel
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3
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Hong GW, Hu H, Chang K, Park Y, Lee KWA, Chan LKW, Yi KH. Review of the Adverse Effects Associated with Dermal Filler Treatments: Part I Nodules, Granuloma, and Migration. Diagnostics (Basel) 2024; 14:1640. [PMID: 39125515 PMCID: PMC11311355 DOI: 10.3390/diagnostics14151640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/24/2024] [Accepted: 07/26/2024] [Indexed: 08/12/2024] Open
Abstract
The increase in the use of filler treatments within minimally invasive cosmetic surgery has correspondingly escalated the variety and frequency of associated side effects. Initially, unregulated procedures led to primary side effects such as infections, foreign body reactions, and granuloma formation. However, severe vascular complications like skin and tissue necrosis and blindness have emerged as recognized risks. Side effects from filler treatments can range from mild to life-threatening, including edema, pain, tenderness, numbness, bleeding, bruising, hematoma, redness, erythema, pigmentation, allergic reactions, itching, pruritus, the Tyndall effect, asymmetry, irregularity, migration, skin and soft tissue infections, nodules, granulomas, and vascular compromise. These side effects are categorized into early and delayed types. Many complications, particularly those related to vascular abnormalities, are frequently linked to procedural issues, emphasizing the importance of understanding filler properties, injection techniques, and facial anatomy. Preventing side effects is ideal, but early detection and treatment are crucial. Recognizing potential side effects based on their timing and understanding appropriate preemptive treatment methods is essential. This discussion addresses non-vascular side effects, highlighting their onset, symptoms, and management strategies. The comprehensive understanding and careful management of these side effects are vital for minimizing complications and ensuring patient safety in filler treatments.
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Affiliation(s)
- Gi-Woong Hong
- Samskin Plastic Surgery Clinic, Seoul 06577, Republic of Korea
| | - Hyewon Hu
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea;
| | | | | | | | | | - Kyu-Ho Yi
- Division in Anatomy and Developmental Biology, Department of Oral Biology, Human Identification Research Institute, BK21 FOUR Project, Yonsei University College of Dentistry, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea;
- Maylin Clinic (Apgujeong), Seoul 06001, Republic of Korea
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4
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Bălăceanu-Gurău B, Dumitrascu A, Giurcăneanu C, Tatar R, Gurău CD, Orzan OA. A Comprehensive Review on the Intricate Interplay between COVID-19 Immunization and the New Onset of Pemphigus Foliaceus. Vaccines (Basel) 2024; 12:857. [PMID: 39203983 PMCID: PMC11360219 DOI: 10.3390/vaccines12080857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 07/19/2024] [Accepted: 07/27/2024] [Indexed: 09/03/2024] Open
Abstract
Autoimmune bullous diseases (AIBDs) are characterized by the formation of vesicles, bullous lesions, and mucosal erosions. The autoantibodies target the cellular anchoring structures from the surface of epidermal keratinocyte named desmosomes, leading to a loss of cellular cohesion named acantholysis. AIBDs are classified into intraepidermal or subepidermal types based on clinical features, histological characteristics, and immunofluorescence patterns. Pemphigus foliaceus (PF) is an acquired, rare, autoimmune skin condition associated with autoantibodies that specifically target desmoglein-1, leading to a clinical presentation characterized by delicate cutaneous blisters, typically sparing the mucous membranes. Several factors, including genetic predisposition, environmental triggers, malignancies, medication use, and vaccination (for influenza, hepatitis B, rabies, tetanus, and more recently, severe acute respiratory syndrome Coronavirus 2 known as SARS-CoV-2), can potentially trigger the onset of pemphigus. With the advent of vaccines playing a pivotal role in combatting the 2019 coronavirus disease (COVID-19), extensive research has been conducted globally to ascertain their efficacy and potential cutaneous adverse effects. While reports of AIBDs post-COVID-19 vaccination exist in the medical literature, instances of PF following vaccination have been less commonly reported worldwide. The disease's pathophysiology is likely attributed to the resemblance between the ribonucleic acid (RNA) antigen present in these vaccines and cellular nuclear matter. The protein produced by the BNT-162b2 messenger ribonucleic acid (mRNA) vaccine includes immunogenic epitopes that could potentially trigger autoimmune phenomena in predisposed individuals through several mechanisms, including molecular mimicry, the activation of pattern recognition receptors, the polyclonal stimulation of B cells, type I interferon production, and autoinflammation. In this review, we present a comprehensive examination of the existing literature regarding the relationship between COVID-19 and PF, delving into their intricate interactions. This exploration improves the understanding of both pemphigus and mRNA vaccine mechanisms, highlighting the importance of close monitoring for PF post-immunization.
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Affiliation(s)
- Beatrice Bălăceanu-Gurău
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.G.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Adrian Dumitrascu
- Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic Florida, Jacksonville, FL 32224, USA;
| | - Călin Giurcăneanu
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.G.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
| | - Raluca Tatar
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
- Department of Plastic Reconstructive Surgery and Burns, “Grigore Alexandrescu” Clinical Emergency Hospital for Children, 010621 Bucharest, Romania
| | - Cristian-Dorin Gurău
- Orthopedics and Traumatology Clinic, Clinical Emergency Hospital, 014451 Bucharest, Romania;
| | - Olguța Anca Orzan
- Department of Oncologic Dermatology, “Elias” Emergency University Hospital, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.G.); (O.A.O.)
- Clinic of Dermatology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania
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5
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Ospina-Gómez JE, Ayala-Gutierrez MC, Amaya Muñoz MC, Cáceres Ramírez C, Monsalve-Suárez EF, Saaibi-Solano DL, Camacho López PA, Latorre-Arevalo MG. Adjuvant-Induced Autoimmune Syndrome: A Bibliometric Analysis. Cureus 2024; 16:e65184. [PMID: 39176357 PMCID: PMC11340253 DOI: 10.7759/cureus.65184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2024] [Indexed: 08/24/2024] Open
Abstract
The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) encompasses various autoimmune conditions triggered by exposure to substances with adjuvant activity. Despite its potential relevance to public health, global scientific production on ASIA syndrome is significantly limited. This knowledge gap underscores the need for a comprehensive bibliometric assessment to understand global research in this field. Therefore, this article aims to conduct a bibliometric analysis to identify and evaluate research trends related to ASIA syndrome worldwide. A Scopus search identified scientific documents published between 2010 and 2022. A total of 2,133 articles meeting inclusion criteria were selected and analyzed for scientific production, authors, and institutions. Two-hundred fifty six documents were analyzed, mostly journal articles with multiple authors. The year with the highest publications was 2023, marking a notable increase since 2021. Italy and Israel had the most documents and citations, correlating with authors Yehuda Shoenfeld (Israel) and Carlo Perricone (Italy). Standout journals are "The Journal of Immunologic Research" and "Lupus." Relevant affiliations include Tel-Aviv University and the National Autonomous University of Mexico. This article identifies and analyzes scientific trends associated with ASIA syndrome. Despite increased publications, this field remains controversial and lacks full acceptance within the medical and scientific community, as evidenced by limited scientific production compared to other pathologies. These findings may motivate researchers to generate impactful publications, contributing to the global knowledge expansion on this syndrome.
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Affiliation(s)
- Juan E Ospina-Gómez
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, COL
| | - Maria C Ayala-Gutierrez
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, COL
| | - Maria C Amaya Muñoz
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, COL
| | - Catalina Cáceres Ramírez
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, COL
| | | | - Diego L Saaibi-Solano
- Rheumatology Department, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, COL
| | - Paul Anthony Camacho López
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, COL
- School of Medicine, Universidad Autónoma de Bucaramanga, Bucaramanga, COL
| | - Maria G Latorre-Arevalo
- Research, Development, and Technological Innovation Department, Fundación Oftalmológica de Santander (FOSCAL), Floridablanca, COL
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6
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Ahmed M, Kurungottu P, Swetha K, Atla S, Ashok N, Nagamalleswari E, Bonam SR, Sahu BD, Kurapati R. Role of NLRP3 inflammasome in nanoparticle adjuvant-mediated immune response. Biomater Sci 2024. [PMID: 38867716 DOI: 10.1039/d4bm00439f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Abstract
The nucleotide-binding oligomerization domain (NOD)-like receptor (NLR) family pyrin domain-containing 3 (NLRP3) inflammasome is pivotal in orchestrating the immune response induced by nanoparticle adjuvants. Understanding the intricate mechanisms underlying the activation of NLRP3 inflammasome by these adjuvants is crucial for deciphering their immunomodulatory properties. This review explores the involvement of the NLRP3 inflammasome in mediating immune responses triggered by nanoparticle adjuvants. It delves into the signaling pathways and cellular mechanisms involved in NLRP3 activation, highlighting its significance in modulating the efficacy and safety of nanoparticle-based adjuvants. A comprehensive grasp of the interplay between NLRP3 inflammasome and nanoparticle adjuvants holds promise for optimizing vaccine design and advancing immunotherapeutic strategies.
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Affiliation(s)
- Momitul Ahmed
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati 781101, India.
| | - Pavithra Kurungottu
- School of Chemistry, Indian Institute of Science Education and Research, Thiruvananthapuram 695551, India.
| | - K Swetha
- School of Chemistry, Indian Institute of Science Education and Research, Thiruvananthapuram 695551, India.
| | - Sandeep Atla
- Texas A&M Drug Discovery Center, Department of Chemistry, Texas A&M University, College Station, Texas 77843, USA
| | - Nivethitha Ashok
- School of Chemistry, Indian Institute of Science Education and Research, Thiruvananthapuram 695551, India.
| | - Easa Nagamalleswari
- MTCC and Gene Bank, CSIR-Institute of Microbial Technology, Sector 39A, Chandigarh, 160036, India
| | - Srinivasa Reddy Bonam
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, USA.
| | - Bidya Dhar Sahu
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Guwahati 781101, India.
| | - Rajendra Kurapati
- School of Chemistry, Indian Institute of Science Education and Research, Thiruvananthapuram 695551, India.
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7
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Piñero-Gutiérrez P, Villar-Álvarez F, Asensio-Mathews P, González-Peinado D. Organizing Pneumonia Secondary to ASIA Syndrome. Arch Bronconeumol 2024:S0300-2896(24)00217-5. [PMID: 38906716 DOI: 10.1016/j.arbres.2024.05.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/23/2024]
Affiliation(s)
| | - Felipe Villar-Álvarez
- Pulmonology Department, IIS Fundación Jiménez Díaz, Madrid, Spain; CIBER Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain; Universidad Autónoma of Madrid, Madrid, Spain.
| | - Paula Asensio-Mathews
- Internal Medicine Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - David González-Peinado
- Department of Plastic and Reconstructive Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
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8
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Saito M, Iijima T, Kurai H, Aso Y. Thyroid storm after coronavirus disease 2019 mRNA vaccination in a patient with a history of Graves' disease after coronavirus disease 2019 infection. BMJ Case Rep 2024; 17:e259796. [PMID: 38834307 DOI: 10.1136/bcr-2024-259796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024] Open
Abstract
We report a case where the patient may have developed Graves' disease after COVID-19 infection, and where the COVID-19 vaccination may have exacerbated the condition, inducing the onset of a thyroid storm. Although any association between the vaccine and the onset of thyroid disease is impossible to demonstrate through a single case, the antecedent COVID-19 infection and COVID-19 messenger ribonucleic acid vaccination may have synergistically contributed to the development of Graves' disease followed by thyroid storm.
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Affiliation(s)
- Masahiro Saito
- Endocrinology and Metabolism, Dokkyo Medical University, Shimotsuga-gun, Japan
| | - Toshie Iijima
- Endocrinology and Metabolism, Dokkyo Medical University, Shimotsuga-gun, Japan
| | - Hidetaka Kurai
- Endocrinology and Metabolism, Dokkyo Medical University, Shimotsuga-gun, Japan
| | - Yosimasa Aso
- Endocrinology and Metabolism, Dokkyo Medical University, Shimotsuga-gun, Japan
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9
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Li Y, Gong Y, Xu G. New insights into kidney disease after COVID-19 infection and vaccination: histopathological and clinical findings. QJM 2024; 117:317-337. [PMID: 37402613 DOI: 10.1093/qjmed/hcad159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 06/23/2023] [Indexed: 07/06/2023] Open
Abstract
In addition to its pulmonary effects, coronavirus disease 2019 (COVID-19) has also been found to cause acute kidney injury (AKI), which has been linked to high mortality rates. In this review, we collected data from 20 clinical studies on post-COVID-19-related AKI and 97 cases of AKI associated with COVID-19 vaccination. Acute tubular injury was by far the most common finding in the kidneys of patients with COVID-19-related AKI. Among patients hospitalized for COVID-19, 34.0% developed AKI, of which 59.0%, 19.1% and 21.9% were Stages 1, 2 and 3, respectively. Though kidney disease and other adverse effects after COVID-19 vaccination overall appear rare, case reports have accumulated suggesting that COVID-19 vaccination may be associated with a risk of subsequent kidney disease. Among the patients with post-vaccination AKI, the most common pathologic findings include crescentic glomerulonephritis (29.9%), acute tubular injury (23.7%), IgA nephropathy (18.6%), antineutrophil cytoplasmic autoantibody-associated vasculitis (17.5%), minimal change disease (17.5%) and thrombotic microangiopathy (10.3%). It is important to note that crescentic glomerulonephritis appears to be more prevalent in patients who have newly diagnosed renal involvement. The proportions of patients with AKI Stages 1, 2 and 3 after COVID-19 vaccination in case reports were 30.9%, 22.7% and 46.4%, respectively. In general, clinical cases of new-onset and recurrent nephropathy with AKI after COVID-19 vaccination have a positive prognosis. In this article, we also explore the underlying pathophysiological mechanisms of AKI associated with COVID-19 infection and its vaccination by describing key renal morphological and clinical features and prognostic findings.
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Affiliation(s)
- Yebei Li
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang 330006, P.R. China
| | - Yan Gong
- Department of Neurosurgery, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang 330006, P.R. China
| | - Gaosi Xu
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, No. 1, Minde Road, Donghu District, Nanchang 330006, P.R. China
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Arron HE, Marsh BD, Kell DB, Khan MA, Jaeger BR, Pretorius E. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: the biology of a neglected disease. Front Immunol 2024; 15:1386607. [PMID: 38887284 PMCID: PMC11180809 DOI: 10.3389/fimmu.2024.1386607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/11/2024] [Indexed: 06/20/2024] Open
Abstract
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a chronic, debilitating disease characterised by a wide range of symptoms that severely impact all aspects of life. Despite its significant prevalence, ME/CFS remains one of the most understudied and misunderstood conditions in modern medicine. ME/CFS lacks standardised diagnostic criteria owing to variations in both inclusion and exclusion criteria across different diagnostic guidelines, and furthermore, there are currently no effective treatments available. Moving beyond the traditional fragmented perspectives that have limited our understanding and management of the disease, our analysis of current information on ME/CFS represents a significant paradigm shift by synthesising the disease's multifactorial origins into a cohesive model. We discuss how ME/CFS emerges from an intricate web of genetic vulnerabilities and environmental triggers, notably viral infections, leading to a complex series of pathological responses including immune dysregulation, chronic inflammation, gut dysbiosis, and metabolic disturbances. This comprehensive model not only advances our understanding of ME/CFS's pathophysiology but also opens new avenues for research and potential therapeutic strategies. By integrating these disparate elements, our work emphasises the necessity of a holistic approach to diagnosing, researching, and treating ME/CFS, urging the scientific community to reconsider the disease's complexity and the multifaceted approach required for its study and management.
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Affiliation(s)
- Hayley E. Arron
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
| | - Benjamin D. Marsh
- MRCPCH Consultant Paediatric Neurodisability, Exeter, Devon, United Kingdom
| | - Douglas B. Kell
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
- The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Lyngby, Denmark
| | - M. Asad Khan
- Directorate of Respiratory Medicine, Manchester University Hospitals, Wythenshawe Hospital, Manchester, United Kingdom
| | - Beate R. Jaeger
- Long COVID department, Clinic St Georg, Bad Aibling, Germany
| | - Etheresia Pretorius
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch, South Africa
- Department of Biochemistry and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, United Kingdom
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11
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Kim MY, Mason HS, Ma JKC, Reljic R. Recombinant immune complexes as vaccines against infectious diseases. Trends Biotechnol 2024:S0167-7799(24)00123-9. [PMID: 38825437 DOI: 10.1016/j.tibtech.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 05/03/2024] [Accepted: 05/10/2024] [Indexed: 06/04/2024]
Abstract
New vaccine technologies are needed to combat many existing infections and prepare better for those that may emerge in the future. The conventional technologies that rely on protein-based vaccines are still severely restricted by the sparsity and poor accessibility of available adjuvants. One possible solution to this problem is to enhance antigen immunogenicity by a more natural means by complexing it with antibodies in the form of immune complexes (ICs). However, natural ICs are impractical as vaccines, and significant research efforts have been made to generate them in recombinant form, with plant bioengineering being at the forefront of these efforts. Here, we describe the challenges and progress made to date to make recombinant IC vaccines applicable to humans.
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Affiliation(s)
- Mi-Young Kim
- St. George's University of London, London, UK; Jeonbuk National University, Jeonju, South Korea
| | - Hugh S Mason
- School of Life Sciences, Arizona State University, Tempe, AZ, USA
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12
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Betancur Henao C, Rifaldo JG, Vicente-Pérez R, Martinez-Avila MC, Daza-Arnedo R, Rico-Fontalvo J. The Autoimmune/Inflammatory Syndrome Induced by Adjuvants (ASIA), Associated with Renal Compromise and Cutaneous Calcinosis: A Case Report and Literature Review. Case Rep Nephrol 2024; 2024:7524714. [PMID: 38774402 PMCID: PMC11108691 DOI: 10.1155/2024/7524714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/06/2024] [Accepted: 04/27/2024] [Indexed: 05/24/2024] Open
Abstract
The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was first introduced in 2011 to provide a more precise syndromic characterization of clinical manifestations observed in patients exposed to adjuvant substances such as biopolymers and silicone, among others. The clinical spectrum of this entity is variable, ranging from local involvement to potentially fatal immune-mediated systemic involvement. The interest in ASIA has grown in recent years, reinforcing diagnostic criteria and deepening the understanding of its pathophysiological behavior. This case report highlights a distinct range of clinical symptoms, such as general symptoms, advanced-stage chronic kidney disease, persistent hypercalcemia with suppressed parathyroid hormone (PTH), bilateral nephrocalcinosis, cutaneous calcinosis, and the presence of positive autoantibodies, emphasizing the significance of understanding this condition.
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Affiliation(s)
| | | | - Rafael Vicente-Pérez
- Division of Nephrology, San Juan de Dios Hospital, Santa Fe de Antioquia, Antioquia, Colombia
- Colombian Association of Nephrology and Hypertension, Bogotá, Colombia
| | - Maria Cristina Martinez-Avila
- Epidemiology and Public Health, Polytechnic University of Nicaragua, Managua, Nicaragua
- Internal Medicine Department, Universidad del Bosque, Bogotá, Colombia
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13
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Borhani-Khomani K, Kalstrup J, Trøstrup H, Henriksen TF, Hölmich LR, Stellander AKL. Self-reported systemic symptoms among women with breast implants. Ugeskr Laeger 2024; 186:V12230801. [PMID: 38808767 DOI: 10.61409/v12230801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
Around 2,500 women receive a breast augmentation with silicone-based implants yearly in Denmark. A number of these women report various uncharacteristic systemic symptoms, which they attribute to the breast implants, including impaired cognition, joint pain, etc. This condition has been termed "breast implant illness" and is currently not a recognised diagnosis. The correlation between the patient's self-reported symptoms and breast implants has not been established and there is limited evidence that surgery has any effect. In this review, the current literature on the topic has been reviewed.
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Affiliation(s)
| | - Julie Kalstrup
- Afdeling for Plastikkirurgi, Københavns Universitetshospital, Herlev og Gentofte Hospital
| | - Hannah Trøstrup
- Plastik- og Brystkirurgisk Afdeling, Sjællands Universitetshospital, Roskilde
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14
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Maitani K, Kadowaki M, Yamagiwa Y, Yasuhara Y, Kozuki S, Otsuka Y, Kubo T, Tomita K. Three Case Reports of Adult-onset Still Disease Associated with Breast Implantation. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e5844. [PMID: 38784828 PMCID: PMC11111390 DOI: 10.1097/gox.0000000000005844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/04/2024] [Indexed: 05/25/2024]
Abstract
Autoimmune syndrome induced by adjuvants (ASIA) is an uncommon clinical condition reported by Shoenfeld et al. Although this syndrome is not scientifically validated, numerous reports on it have been published, and the manifestations are postulated to be diverse, including generalized symptoms such as chronic fatigue, myalgia, arthralgia, or dry mouth, induced by exogenous substances, specifically adjuvants, which can encompass vaccines, organisms, and silicone. Concurrently, adult-onset Still disease (AOSD) is also an infrequent ailment, characterized by spiking fever, arthritis, skin rash, lymphadenopathy, and serositis. Although the precise pathogenesis remains incompletely understood, some case reports suggest that ASIA may be at the root of AOSD development with the same instigator. In this context, we present three cases of patients diagnosed with AOSD, which possibly could be considered an association with ASIA, years after undergoing breast reconstruction with silicone breast implants. In one case, the patient solely received medical treatment due to her refusal to have the implant removed, resulting in multiple flares and severe complications related to glucocorticoid therapy. Conversely, in the other two cases, a combination of immunosuppressive therapy and silicone breast implant explantation led to the complete resolution of clinical symptoms. To the best of our knowledge, there are only 10 documented case reports of AOSD associated with silicone breast implants insertion. We believe this report serves as a complementary addition to prior research and offers further insights into the ongoing debate about whether explantation should be carried out early in the clinical course or not.
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Affiliation(s)
- Kosuke Maitani
- From the Department of Plastic and Reconstructive Surgery, Sakai City Medical Center, Osaka, Japan
| | - Miki Kadowaki
- From the Department of Plastic and Reconstructive Surgery, Sakai City Medical Center, Osaka, Japan
| | - Yuko Yamagiwa
- From the Department of Plastic and Reconstructive Surgery, Sakai City Medical Center, Osaka, Japan
| | - Yumiko Yasuhara
- Department of Diagnostic Pathology, Sakai City Medical Center, Osaka, Japan
| | - Shino Kozuki
- From the Department of Plastic and Reconstructive Surgery, Sakai City Medical Center, Osaka, Japan
| | - Yohei Otsuka
- Department of Internal Medicine, Sakai City Medical Center, Osaka, Japan
| | - Tateki Kubo
- Department of Plastic and Reconstructive Surgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Koichi Tomita
- Department of Plastic and Reconstructive Surgery, Kindai University Faculty of Medicine, Osaka, Japan
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15
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Badran G, Grare C, Masson JD, David MO, Achour D, Guidice JML, Garçon G, Crépeaux G. Difference in the cellular response following THP-1 derived phagocytic monocyte cells exposure to commercial aluminum-based adjuvants and aluminum-containing vaccines. J Trace Elem Med Biol 2024; 83:127394. [PMID: 38262194 DOI: 10.1016/j.jtemb.2024.127394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 01/12/2024] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Aluminum-based adjuvants (ABAs) enhance the immune response following vaccine injection. Their mechanisms of action are not fully understood, and their bio-persistency have been described associated with long-term adverse effects. METHODS We evaluated and compared the cellular effects of the two main ABAs and whole vaccines on ATP production, ROS generation and cytokines production (IL-6 and IL-10), using THP-1 cells. RESULTS ABAs altered the cell energy metabolism by increasing ROS production after 24 h and reducing ATP production after 48 h. In addition, both ABAs and whole vaccines induced different kinetics of IL-6 production, whereas only ABAs induced IL-10 secretion. CONCLUSION This study showed clearly, for a first time, a difference in cellular response to the ABAs and whole vaccines which should be taken into consideration in future studies focusing on the effect of ABA in vaccines. Future studies on ABAs should also pay attention to mitochondrial function alterations following exposure to ABA-containing vaccines.
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Affiliation(s)
- Ghidaa Badran
- Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France.
| | - Céline Grare
- CHU Lille, Institut Pasteur de Lille, ULR 4483-IMPacts de l'Environnement Chimique sur la Santé (IMPECS), Univ. Lille, Lille, France
| | | | - Marie-Odile David
- Université Paris-Saclay, Inserm, Univ Evry, Structure-Activité des Biomolécules Normales et Pathologiques, U1204, 91025 Evry, France
| | - Djamal Achour
- CHU Lille, Institut Pasteur de Lille, ULR 4483-IMPacts de l'Environnement Chimique sur la Santé (IMPECS), Univ. Lille, Lille, France
| | - Jean-Marc Lo Guidice
- CHU Lille, Institut Pasteur de Lille, ULR 4483-IMPacts de l'Environnement Chimique sur la Santé (IMPECS), Univ. Lille, Lille, France
| | - Guillaume Garçon
- CHU Lille, Institut Pasteur de Lille, ULR 4483-IMPacts de l'Environnement Chimique sur la Santé (IMPECS), Univ. Lille, Lille, France
| | - Guillemette Crépeaux
- Univ Paris Est Créteil, INSERM, IMRB, F-94010 Créteil, France; Ecole Nationale Vétérinaire d'Alfort, IMRB, F-94700 Maisons-Alfort, France
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16
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Caron P, Imbert P, Dekeister C, Grunenwald S. Concurrent pretibial myxedema and thyroid eye disease following mRNA COVID-19 vaccine in a patient with history of Graves' disease. ANNALES D'ENDOCRINOLOGIE 2024; 85:100-103. [PMID: 37866430 DOI: 10.1016/j.ando.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/09/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
A 70-year-old female had a history of thyroid surgery for benign nodules and Graves' disease. Following mRNA COVID-19 vaccination, she presented Graves' orbitopathy and pretibial myxedema. Symptoms of thyroid eye disease and thyroid dermopathy improved after 500-mg methylprednisolone infusions.
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Affiliation(s)
- Philippe Caron
- Consultation multidisciplinaire des orbitopathies, Service d'endocrinologie et maladies métaboliques, pôle cardiovasculaire et métabolique, CHU de Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France.
| | - Philippe Imbert
- Consultation multidisciplinaire des orbitopathies, Service d'endocrinologie et maladies métaboliques, pôle cardiovasculaire et métabolique, CHU de Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France
| | - Céline Dekeister
- Consultation multidisciplinaire des orbitopathies, Service d'endocrinologie et maladies métaboliques, pôle cardiovasculaire et métabolique, CHU de Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France
| | - Solange Grunenwald
- Consultation multidisciplinaire des orbitopathies, Service d'endocrinologie et maladies métaboliques, pôle cardiovasculaire et métabolique, CHU de Larrey, 24, chemin de Pouvourville, TSA 30030, 31059 Toulouse cedex, France
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17
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Rio P, Caldarelli M, Chiantore M, Ocarino F, Candelli M, Gasbarrini A, Gambassi G, Cianci R. Immune Cells, Gut Microbiota, and Vaccines: A Gender Perspective. Cells 2024; 13:526. [PMID: 38534370 DOI: 10.3390/cells13060526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Revised: 03/11/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
The development of preventive and therapeutic vaccines has played a crucial role in preventing infections and treating chronic and non-communicable diseases, respectively. For a long time, the influence of sex differences on modifying health and disease has not been addressed in clinical and preclinical studies. The interaction of genetic, epigenetic, and hormonal factors plays a role in the sex-related differences in the epidemiology of diseases, clinical manifestations, and the response to treatment. Moreover, sex is one of the leading factors influencing the gut microbiota composition, which could further explain the different predisposition to diseases in men and women. In the same way, differences between sexes occur also in the immune response to vaccines. This narrative review aims to highlight these differences, focusing on the immune response to vaccines. Comparative data about immune responses, vaccine effectiveness, and side effects are reviewed. Hence, the intricate interplay between sex, immunity, and the gut microbiota will be discussed for its potential role in the response to vaccination. Embracing a sex-oriented perspective in research may improve the efficacy of the immune response and allow the design of tailored vaccine schedules.
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Affiliation(s)
- Pierluigi Rio
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Mario Caldarelli
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Monica Chiantore
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Francesca Ocarino
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Marcello Candelli
- Department of Emergency, Anesthesiological and Reanimation Sciences, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Antonio Gasbarrini
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Giovanni Gambassi
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
| | - Rossella Cianci
- Department of Translational Medicine and Surgery, Catholic University of Rome, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
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18
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Wollina U, Goldman A, Kocic H, Andjelkovic T, Bogdanovic D, Kokić IK. Impurities in Hyaluronic Acid Dermal Fillers? A Narrative Review on Nonanimal Cross-Linked Fillers. Facial Plast Surg Aesthet Med 2024; 26:190-194. [PMID: 38387011 DOI: 10.1089/fpsam.2023.0294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Importance: Nonanimal cross-linked hyaluronic acid (HA) dermal fillers are among the most versatile tools in minimal invasive esthetic medicine. Filler injections aim to volumize, provide contour, and reduce wrinkles and skinfolds. In the hand of the experienced user, HA fillers have an excellent safety profile. Nevertheless, adverse events have been reported related to poor injection techniques, infection, and immune reactions. Observations: In this review, the focus is on filler impurities. Impurities can originate from the fermentation process, crosslinking, packaging, and contamination. Impurities consist of particular and nonparticular matter. We discuss possible risks for the patient to be treated with HA fillers. Conclusions and Relevance: Impurities of dermal fillers bear a potential risk for patients, such as delayed autoimmune and inflammatory reactions, biofilm formation, and exposure to leachable Endocrine Disrupting Chemicals. Amount and quality of impurities can be considered as one of the quality parameters of commercially fillers. Considering patient safety, filler impurities should be further reduced.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Municipal Hospital Dresden, Academic Teaching Hospital, Dresden, Germany
| | - Alberto Goldman
- Department of Plastic Surgery, Hospital São Lucas da PUCRS, Porto Alegre/RS, Brazil
| | - Hristina Kocic
- Clinic for Skin and Venereal Diseases, UCC Nis, Medical Faculty, University of Nis, Nis, Serbia
| | - Tatjana Andjelkovic
- Department of Chemistry, Faculty of Science and Mathematics, University of Niš, Niš, Serbia
| | - Danica Bogdanovic
- Department of Chemistry, Faculty of Science and Mathematics, University of Niš, Niš, Serbia
| | - Ivana Kostić Kokić
- Department of Chemistry, Faculty of Science and Mathematics, University of Niš, Niš, Serbia
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19
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Di Via Ioschpe A, Oleru OO, Brozynski M, Seyidova N, Henderson PW. Contextualizing the Impact of Pop Culture on Breast Implant Illness and its Medical Relevance. Aesthetic Plast Surg 2024; 48:1056-1065. [PMID: 37486364 PMCID: PMC11000431 DOI: 10.1007/s00266-023-03422-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/11/2023] [Indexed: 07/25/2023]
Abstract
INTRODUCTION Despite a lack of data demonstrating causation, there is growing concern over breast implants and systemic illness. This study examines the impact of rising public interest in breast implant illness (BII) and its implications on breast implant removals (BIR). METHODS A Google Trends (GT) analysis of each year between 2010 and 2022 was performed globally, and then separately for the United States alone (US), using the search terms "capsular contracture," "breast implant illness," and "breast implant(s) removal". Linear regression was performed to determine significant correlations. Data on BII-related Facebook advocacy groups, relevant pop culture events, numbers of BIR surgeries, and number of BII-related publications were collected and analyzed alongside GT data to determine relevance. RESULTS For global GT, there was a significant relationship between "breast implant illness" and "breast implant(s) removal" in 2016 (R2=0.62, β =0.33, p<0.01), 2020 (R2=0.53, β =0.23, p=0.01), and 2022 (R2=0.60, β =0.44, p=0.01). In the US, 2016 (R2=0.53, β =1.75, p=0.01) 2018 (R2=0.61, β =1.93, p<0.01) and 2020 (R2=0.72, β=0.91, p<0.01) were significant. In 2020, "capsular contracture" and "breast implant(s) removal" was significant in the US (R2=0.58, β=0.4, p=0.01). In 2016, Facebook was the platform for the largest BII advocacy group and in 2020 YouTube was the platform for the first BII documentary and TEDx talk. From 2010 to 2020, PubMed publications containing "ASIA" and "BII" increased 24-fold and ASPS reports on BIR rose 70%. CONCLUSION This study suggests that BII is a topic of global concern and has implications on both academic medicine and clinical practice. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Anaïs Di Via Ioschpe
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 2L, New York, NY, 10003, USA
| | - Olachi O Oleru
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 2L, New York, NY, 10003, USA
| | - Martina Brozynski
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 2L, New York, NY, 10003, USA
| | - Nargiz Seyidova
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 2L, New York, NY, 10003, USA
| | - Peter W Henderson
- Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, 10 Union Square East, Suite 2L, New York, NY, 10003, USA.
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20
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Kanuri SH, Sirrkay PJ. Adjuvants in COVID-19 vaccines: innocent bystanders or culpable abettors for stirring up COVID-heart syndrome. Ther Adv Vaccines Immunother 2024; 12:25151355241228439. [PMID: 38322819 PMCID: PMC10846003 DOI: 10.1177/25151355241228439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 01/05/2024] [Indexed: 02/08/2024] Open
Abstract
COVID-19 infection is a multi-system clinical disorder that was associated with increased morbidity and mortality. Even though antiviral therapies such as Remdesvir offered modest efficacy in reducing the mortality and morbidity, they were not efficacious in reducing the risk of future infections. So, FDA approved COVID-19 vaccines which are widely administered in the general population worldwide. These COVID-19 vaccines offered a safety net against future infections and re-infections. Most of these vaccines contain inactivated virus or spike protein mRNA that are primarily responsible for inducing innate and adaptive immunity. These vaccines were also formulated to contain supplementary adjuvants that are beneficial in boosting the immune response. During the pandemic, clinicians all over the world witnessed an uprise in the incidence and prevalence of cardiovascular diseases (COVID-Heart Syndrome) in patients with and without cardiovascular risk factors. Clinical researchers were not certain about the underlying reason for the upsurge of cardiovascular disorders with some blaming them on COVID-19 infections while others blaming them on COVID-19 vaccines. Based on the literature review, we hypothesize that adjuvants included in the COVID-19 vaccines are the real culprits for causation of cardiovascular disorders. Operation of various pathological signaling events under the influence of these adjuvants including autoimmunity, bystander effect, direct toxicity, anti-phospholipid syndrome (APS), anaphylaxis, hypersensitivity, genetic susceptibility, epitope spreading, and anti-idiotypic antibodies were partially responsible for stirring up the onset of cardiovascular disorders. With these mechanisms in place, a minor contribution from COVID-19 virus itself cannot be ruled out. With that being said, we strongly advocate for careful selection of vaccine adjuvants included in COVID-19 vaccines so that future adverse cardiac disorders can be averted.
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Affiliation(s)
- Sri Harsha Kanuri
- Research Fellow, Stark Neurosciences Institute, Indiana University School of Medicine, 320 W 15 ST, Indianapolis, IN 46202, USA
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21
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Gabrielli R, Siani A, Smedile G, Rizzo AR, De Vivo G, Accrocca F, Bartoli S. Isolated popliteal artery lesion due to giant cell vasculitis post COVID-19 mRNA vaccine and COVID-19 asymptomatic infection. Vascular 2024; 32:226-230. [PMID: 36200437 PMCID: PMC9535462 DOI: 10.1177/17085381221126234] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Giant cell arteritis (GCA) is a rare granulomatous vasculitis, affecting medium and large vessels, usually in old patients. The incidence of GCA has been higher during current COVID-19 pandemia and COVID-19 is recognized for its immune dysregulation. Lower limbs involvement is uncommon but can be limb threatening, resulting in limb loss. METHOD A 43-year-old man presented with a sudden pain in his right calf and foot associated with pallor and hypothermia, and there was objective evidence of ischemia. Symptoms began few days after he received the first dose of a COVID-19 mRNA vaccine and COVID-19 asymptomatic infection 20 days after vaccination. He had no history of any signs of claudication pre-COVID or limb trauma and was very fit.Enhanced computed tomography and magnetic resonance imaging (MRI)suggest diagnosis of popliteal artery cystic adventitial disease. We resected the affected popliteal artery with interposition using a right great saphenous vein graft, through a posterior approach. On the fourth postoperative day, he was discharged.Histopathological examination revealed patchy intramural inflammatory infiltrates composed of lymphocytes and rare multinucleated giant cells at the internal lamina and adventitia consistent with a diagnosis of GCA. CONCLUSION AND RESULT Our case represents the first reported case of isolated popliteal GCA following vaccination with a COVID-19 mRNA vaccine and COVID-19 infection. We propose that the upregulated immune response to the vaccine acted as a trigger for GCA in this patient with predisposing risk factors and recurrent and repetitive microtrauma in popliteal fossa (the patient is a professional runner). Our case suggests the need for further studies about real world incidence of GCA associated vaccination and COVID-19 infection. Currently, data is limited regarding this relationship. We continue to encourage COVID-19 vaccination, even in elderly patients because the benefits of vaccination far outweigh any theoretical risk of immune dysregulation following administration.
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Affiliation(s)
- Roberto Gabrielli
- Unit of Vascular, Endovascular and Emergency Vascular Surgery, “S. Eugenio” Hospital, Rome, Italy
| | - Andrea Siani
- Unit of Vascular, Endovascular and Emergency Vascular Surgery, “S. Eugenio” Hospital, Rome, Italy
| | - Gianluca Smedile
- Unit of Vascular, Endovascular and Emergency Vascular Surgery, “S. Eugenio” Hospital, Rome, Italy
| | - Anna Rita Rizzo
- Unit of Vascular, Endovascular and Emergency Vascular Surgery, “S. Eugenio” Hospital, Rome, Italy
| | - Gennaro De Vivo
- Unit of Vascular, Endovascular and Emergency Vascular Surgery, “S. Eugenio” Hospital, Rome, Italy
| | - Federico Accrocca
- Unit of Vascular, Endovascular and Emergency Vascular Surgery, “S. Eugenio” Hospital, Rome, Italy
| | - Stefano Bartoli
- Unit of Vascular, Endovascular and Emergency Vascular Surgery, “S. Eugenio” Hospital, Rome, Italy
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22
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Kushida-Contreras BH, Gómez-Calva B, Mendoza-Ramírez B, Gaxiola-García MA. Autoimmune Autoinflammatory Syndrome Induced by Adjuvants (ASIA) After Injection of Foreign Materials for Cosmetic Purposes: Retrospective Analysis of 1027 Cases. Aesthetic Plast Surg 2024; 48:491-500. [PMID: 37775577 DOI: 10.1007/s00266-023-03670-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 09/09/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND The injection of illicit, non-regulated foreign materials may trigger an autoimmune autoinflammatory syndrome induced by adjuvants (ASIA). METHODS A retrospective review of health records was performed to identify patients' epidemiological and clinical characteristics. The issues analyzed were age and gender of cases, occupation, the person who administered the substance, anatomical site, type and volume of the injected substance, time from injection to the onset of symptoms, chief complaint, measures taken to alleviate symptoms, local complications, systemic manifestations, and imaging method to aid in diagnosis. RESULTS More than 70% of patients were female and dedicated to household activities; the mean age was 44 years for females and 40.7 years for males. One-quarter of patients reported some comorbidity. The most commonly reported substance was mineral oil, whereas the most frequent anatomical site was the gluteal region with volumes around one liter. Signs and symptoms occurred almost exclusively at a local level, pain (40%) and swelling (18%) being the predominant manifestations with a peak incidence after three years. Treatment was mainly medical; surgery, primarily en bloc resection, was performed in 20% of patients. CONCLUSIONS A myriad of substances may induce autoimmune autoinflammatory syndrome induced by adjuvants (ASIA) when injected for cosmetic purposes. Since effective treatments are scarce, public policies should be enforced to alert the community and limit the consequences of this healthcare problem. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
| | - Brenda Gómez-Calva
- National Autonomous University of Mexico (Universidad Nacional Autónoma de México, UNAM), Mexico City, Mexico
| | - Bruno Mendoza-Ramírez
- National Autonomous University of Mexico (Universidad Nacional Autónoma de México, UNAM), Mexico City, Mexico
| | - Miguel Angel Gaxiola-García
- Plastic and Reconstructive Surgery Department, Mexico's Children's Hospital (Hospital Infantil de México "Federico Gómez"), Mexico City, Mexico.
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23
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Elroy T, Halpert G, Tsur AM, Heidecke H, Amital H, Shoenfeld Y. Palpitation in women with silicone breast implants: association with autoantibodies against autonomic nervous system. Immunol Res 2024; 72:155-161. [PMID: 37845561 DOI: 10.1007/s12026-023-09425-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 09/23/2023] [Indexed: 10/18/2023]
Abstract
We explored a possible association between palpitation manifestation in women with silicone breast implants (SBIs) with circulating level of autoantibodies directed against autonomic nervous system (ANS) receptors. The study was conducted in 93 women with SBIs who arrived to our clinic with diverse symptoms thought to be associated with their implants. Titers of 11 various autoantibodies were measured in the sera of women with SBIs who experienced palpitations (Palpitations, n = 47), did not experience palpitations (Non, n = 46), and healthy women (Control, n = 36). A significant reduction in anti-α2-adrenergic receptor (A2AR, P = 0.035), anti-β2-adrenergic receptor (B2AR, P = 0.027), antimuscarinic receptors M1R (P = 0.048), and anti-M2R (P = 0.039) autoantibodies was found in the 'Palpitations' group as compared with the 'Non' group. Anti-B2AR (P = 0.042), anti-M1R (P = 0.017), and anti-M2R (P = 0.0015) autoantibodies were also significantly reduced in 'Palpitations' as compared with the 'Control' group. Our study shows possible association between autoantibodies directed against ANS receptors, with existing complaints of palpitations in women with SBIs.
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Affiliation(s)
- Tal Elroy
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Gilad Halpert
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, 52621, Ramat-Gan, Israel
| | - Avishai M Tsur
- Department of Medicine 'B' and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat-Gan, Israel
- Israel Defense Forces, Medical Corps, Tel Hashomer, Ramat Gan, Israel
- Department of Military Medicine, Hebrew University of Jerusalem Faculty of Medicine, Jerusalem, Israel
| | | | - Howard Amital
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Medicine 'B' and Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Ramat-Gan, Israel
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, 52621, Ramat-Gan, Israel
- Reichman University, Herzelia, Israel
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24
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Lampropoulou E, Benz C, Kahaly GJ, Führer D. Thyroid Inflammation and Immunity During the COVID-19 Pandemic: A Comprehensive Review and Case Study. Horm Metab Res 2024; 56:111-117. [PMID: 38049146 DOI: 10.1055/a-2222-6300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to the development of various vaccines. Reports have emerged suggesting a possible association between SARS-CoV-2 vaccination and the onset of thyroid diseases. This review explores the clinical aspects of thyroid disorders following SARS-CoV-2 vaccination, including a case report of a patient with concomitant subacute thyroiditis (SAT) and Graves' disease (GD) with blocking thyrotropin receptor autoantibodies (TSH-R-Ab) following SARS-CoV-2 vaccination. SAT, characterized by transient inflammation of the thyroid gland, has been reported after SARS-CoV-2 vaccination. GD, an autoimmune hyperthyroidism, has also been observed post-vaccination, often with stimulating TSH-R-Ab. Graves' orbitopathy (GO) has been associated with SARS-CoV-2 vaccination in patients with a history of immune thyroid disease. The unique case underscores a very rare thyroid condition of functional hypothyroidism in possible relation to SARS-CoV-2 vaccination and the usefulness of functional analysis of TSH-R-Ab that can provide valuable insights into disease pathogenesis and help to guide treatment. This review highlights the need for continued monitoring and awareness of potential thyroid-related complications following SARS-CoV-2 vaccination.
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Affiliation(s)
- Eleni Lampropoulou
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, Essen, Germany
| | - Claus Benz
- Department of Gastroenterology, Ev. Klinikum Koeln-Weyertal, Koeln, Germany
| | - George J Kahaly
- Dept. of Medicine I, Gutenberg University Hospital, Mainz, Germany
| | - Dagmar Führer
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, Essen, Germany
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Kushida-Contreras BH, Gómez-Calva B, Gaxiola-García MA. Cosmetic Injection of Illicit Foreign Materials: Imaging Features and Patterns of Migration in 413 Cases. Aesthet Surg J 2024; 44:183-191. [PMID: 37863473 DOI: 10.1093/asj/sjad336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/13/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND The injection of illicit, nonregulated foreign materials is increasingly common and has negative consequences relative to the inflammatory process that ensues. OBJECTIVES The aim of this study was to identify anatomical and imaging characteristics after the cosmetic injection of illicit foreign materials. METHODS A retrospective review of clinical and imaging records was performed. The issues analyzed were the anatomical site, type of injected substance, imaging method for diagnosis, and patterns of migration. RESULTS Data on 413 patients were collected. Most patients were female, with a mean age of 44 years. The most commonly infiltrated region was the buttocks (n = 284; 53.58%) followed by the breast (n = 99; 18.67%). Magnetic resonance imaging was the most common method of diagnosis in those patients who had an imaging study (159 out of 168). The most frequent depth of foreign material detected by imaging was the muscular plane (n = 103; 61.30%). Migration was detected in 56.55% of patients who had an imaging study. Most infiltrated substances were unknown; biopolymers were the most commonly identified substances. Depending on the type of substance, migration rates varied from 13% to 29%; rate differences were not statistically significant (P = .712). Migration was more common when the depth of infiltration was in muscle (77.66%) than in subcutaneous tissue (23.4%); this difference was statistically significant (P < .0001). CONCLUSIONS Deep infiltration is related to greater migration rates, apparently regardless of the substance injected. LEVEL OF EVIDENCE: 3
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Banjongjit A, Thammathiwat T, Townamchai N, Kanjanabuch T. SARS-CoV-2 infection associated with antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (ANCA-GN): a systematic review and two case reports. J Nephrol 2024; 37:53-63. [PMID: 37930464 DOI: 10.1007/s40620-023-01777-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 09/03/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND It has been observed that SARS-CoV-2 infections are associated with the development of various de-novo autoimmune diseases; little is known on new-onset antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (ANCA-GN) after SARS-CoV-2 infections. METHODS We conducted a systematic review of previously reported cases with a presumed association of new-onset antineutrophil cytoplasmic antibody-associated glomerulonephritis (ANCA-GN). No language restrictions were applied during the search. The eligible articles included reports of biopsy-proven pauci-immune glomerulonephritis that occurred following SARS-CoV-2 infection. The review was registered in PROSPERO database (CRD42023407786). Two further cases are reported. RESULTS The mean age of SARS-CoV-2 infection-associated ANCA-GN was 48 ± 19 years. Fifty-six percent of patients showed positivity for myeloperoxidase (MPO)-ANCA. Among tested patients, 36% had concomitantly positive antinuclear antibodies, and 100% had positive rheumatoid factor. Eleven out of the 21 cases (55%) were diagnosed with ANCA-GN during hospitalization due to SARS-CoV-2 infection. The remaining cases were diagnosed after a median of 2.1 months following COVID-19. Seventy-one percent of patients showed improvement in kidney function following different treatments. CASE REPORTS one patient had positive p-ANCA and cryoglobulin. Another case had positive MPO-ANCA, c-ANCA, cryoglobulinemia, and rheumatoid factor. CONCLUSION SARS-CoV-2 infection-associated ANCA-GN patients are younger than primary ANCA-GN patients. The presence of atypical ANCA along with co-positivity with other autoantibodies can raise suspicion for SARS-CoV-2 infection-associated ANCA-GN.
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Affiliation(s)
- Athiphat Banjongjit
- Nephrology Unit, Department of Medicine, Vichaiyut Hospital, Bangkok, Thailand
| | | | - Natavudh Townamchai
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Renal Immunology and Renal Transplant Research Unit, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Talerngsak Kanjanabuch
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
- Peritoneal Dialysis Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
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27
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Tervaert JWC, Shoenfeld Y, Cruciani C, Scarpa C, Bassetto F. Breast implant illness: Is it causally related to breast implants? Autoimmun Rev 2024; 23:103448. [PMID: 37714420 DOI: 10.1016/j.autrev.2023.103448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/12/2023] [Indexed: 09/17/2023]
Abstract
Once believed to be completely inert implants, Silicon Breast Implants (SBIs) have been shown to be able to induce a chronic inflammatory response in the body which can lead to a variety of possible manifestations ranging from the most common capsular contraction to rarer conditions such as malignancies and autoimmune diseases. Among the latter, new syndromes have been consistently recognized: Breast Implant Illness (BII) and autoimmunity/autoinflammatory syndrome induced by adjuvants (ASIA syndrome/Shoenfeld's Syndrome). The pathophysiological mechanisms underlying such syndromes are not yet clear and the overlap they show with other common conditions have sparked an important debate in the scientific community regarding their existence and their cause-effect relationship with SBIs. In this article Professor Cohen Tervaert and Professor Bassetto, leading experts in the field, are going to present arguments in favor and against such causal relationship according to the latest scientific evidence. Professor Cohen Tervaert is going to demonstrate how the evidence available is enough to prove a causal relationship as defined by the Bradford Hill's criteria. Professor Bassetto is going to highlight how the many biases that afflict the available evidence prevent us from drawing such conclusions. Professor Shoenfeld is going to moderate the discussion with its insightful conclusions.
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Affiliation(s)
- Jan Willem Cohen Tervaert
- Division of Rheumatology, Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; School for Mental Health and Neurosciences (MHeNs), Maastricht University, Maastricht, the Netherlands
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Reichman University, Herzliya, Israel..
| | - Claudio Cruciani
- Division of Rheumatology, Department of Internal Medicine, Azienda Ospedaliera di Padova, University of Padova, Padova, Veneto, Italy
| | - Carlotta Scarpa
- Unit of Plastic and Reconstruction Surgery, Azienda Ospedaliera di Padova, University of Padova, Padova, Veneto, Italy
| | - Franco Bassetto
- Unit of Plastic and Reconstruction Surgery, Azienda Ospedaliera di Padova, University of Padova, Padova, Veneto, Italy
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28
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Arefzadeh A. A Review of Thyroid Dysfunction Due to COVID-19. Mini Rev Med Chem 2024; 24:265-271. [PMID: 37069724 DOI: 10.2174/1389557523666230413090332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 02/14/2023] [Accepted: 02/20/2023] [Indexed: 04/19/2023]
Abstract
Coronavirus disease 2019 (COVID-19) affects thyroid function. These changes are due to the direct impact of the virus on thyroid cells via angiotensin-converting-enzyme 2 (ACE2) receptors, inflammatory reaction, apoptosis in thyroid follicular cells, suppression of hypothalamus-pituitarythyroid axis, an increase in activity of adrenocortical axis, and excess cortisol release due to cytokine storm of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Euthyroid sick syndrome (ESS), thyroiditis, clinical and subclinical hypothyroidism, central hypothyroidism, exacerbation of underlying autoimmune thyroid disease, and clinical and subclinical hyperthyroidism can be associated with coronavirus. Adjuvants in coronavirus vaccines induce autoimmune/inflammatory syndrome known as vaccine adjuvants (ASIA) syndrome. Thyroiditis and Graves' disease have been reported to be associated with ASIA syndrome after some coronavirus vaccinations. Some coronavirus medications, such as hydroxychloroquine, monoclonal antibodies, lopinavir/ritonavir, remdesivir, naproxen, anticoagulants, and glucocorticoids can also affect thyroid tests, and correct diagnosis of thyroid disorders will be more difficult. Changes in thyroid tests may be one of the most important manifestations of COVID-19. These changes can be confusing for clinicians and can lead to inappropriate diagnoses and decisions. Prospective studies should be conducted in the future to increase epidemiological and clinical data and optimize the management of thyroid dysfunctions in patients with COVID-19.
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Affiliation(s)
- Alireza Arefzadeh
- Department of Endocrinology, Farhikhtegan Hospital, Faculty of Medicine, Tehran Medical Sciences Islamic Azad University, Tehran, Iran
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29
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Tanev D, Marinchev L, Robeva R. Autoimmune/auto-inflammatory syndrome induced by adjuvant (ASIA) in patients refusing breast implant explantation: two case reports and a review of the literature. BIOTECHNOL BIOTEC EQ 2023. [DOI: 10.1080/13102818.2022.2151377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Affiliation(s)
- Dobromir Tanev
- Department of Rheumatology, University Hospital UMHAT SofiaMed, Faculty of Medicine, Sofia University St. Kl. Ohridski, Sofia, Bulgaria
| | - Lyubomir Marinchev
- Department of Rheumatology, University Hospital UMHAT SofiaMed, Faculty of Medicine, Sofia University St. Kl. Ohridski, Sofia, Bulgaria
| | - Ralitsa Robeva
- Department of Endocrinology, University Hospital USHATE Acad. Iv. Penchev, Faculty of Medicine, Medical University of Sofia, Sofia, Bulgaria
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30
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Sachin J, Shukla R, Anil A, Saravanan A, Santhyavu S, Varthya SB, Ambwani S, Singh S. COVISHIELD vaccine-induced thyroiditis: a case report. J Med Case Rep 2023; 17:542. [PMID: 38098118 PMCID: PMC10722757 DOI: 10.1186/s13256-023-04279-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Accepted: 11/17/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The rapid development of coronavirus disease 2019 vaccines during the pandemic has left their long-term effects largely unknown. Instances of autoimmune and subacute thyroiditis showing features of autoimmune/inflammatory syndrome induced by adjuvants have been reported post-vaccination. This case report aims to highlight the autoimmune/inflammatory syndrome induced by adjuvants syndrome after coronavirus disease 2019 vaccination, drawing attention to a possible connection with thyroid dysfunction and urging for further thorough research. CASE PRESENTATION We present a case of thyroiditis induced by the COVISHIELD vaccine in a 37-year-old Indian woman. An apparently normal and healthy adult woman developed neck pain and easy fatigability 2 weeks after the second dose of COVISHIELD, which gradually increased and was associated with irritability, decreased sleep, excessive sweating, tremor, palpitation, and weight loss. She presented to the outpatient department after 1 week of symptoms and was evaluated with laboratory tests and imaging. She was diagnosed with thyroiditis due to the coronavirus disease 2019 vaccine and was treated with propranolol. CONCLUSION This case report adds to the growing evidence of coronavirus disease 2019 vaccine-related thyroid issues. The development of thyroiditis is rare and underreported post-coronavirus disease 2019 vaccination; hence, research to evaluate the association of coronavirus disease 2019 vaccines with thyroid dysfunction needs to be done in the future.
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Affiliation(s)
- J Sachin
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Ravindra Shukla
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Abhishek Anil
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Aswini Saravanan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Sanjay Santhyavu
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Shoban Babu Varthya
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Sneha Ambwani
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Surjit Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India.
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31
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Hwang YK, Kwak HH, Yun JE, Kim SH, Chang YS. Eosinophilic Granulomatosis With Polyangiitis Following COVID-19 Vaccination: A Case Report. J Korean Med Sci 2023; 38:e382. [PMID: 38084026 PMCID: PMC10713438 DOI: 10.3346/jkms.2023.38.e382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/13/2023] [Indexed: 12/18/2023] Open
Abstract
The current emergence of the coronavirus disease 2019 (COVID-19) pandemic and the possible side effects of COVID-19 mRNA vaccination remain worrisome. Few cases of vaccination-related side effects, such as vasculitis, have been reported. Eosinophilic granulomatosis with polyangiitis (EGPA), also known as Churg-Strauss syndrome, is a type of vasculitis characterized by the histological richness of eosinophils, asthma, polyneuropathy, sinusitis, and skin or lung involvement. Here, we report the first case of new onset EGPA following COVID-19 vaccination in Korea. A 71-year old woman developed a skin rash and presented with progressive weakness of the upper and lower extremities after the BNT162b2 vaccination (Pfizer-BioNTech). She was diagnosed with EGPA and her symptoms improved after systemic steroid and immunosuppressant therapy. Although it is very rare, clinicians should be aware that EGPA may occur after COVID-19 vaccination.
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Affiliation(s)
- Yu-Kyoung Hwang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Hui-Hwan Kwak
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Jeong-Eun Yun
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sae-Hoon Kim
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Medical Research Center, Seoul National University, Seoul, Korea
| | - Yoon-Seok Chang
- Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
- Medical Research Center, Seoul National University, Seoul, Korea.
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32
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Herrero-Ruiz SP, Garrido-Ríos AA, Fernández de la Fuente L, Baeza-Hernández G, Echeverría-García B, Borbujo J. A case of systemic lupus erythematosus in the context of ASIA syndrome because of silicone breast implants. Int J Dermatol 2023; 62:1549-1550. [PMID: 37767717 DOI: 10.1111/ijd.16866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/29/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Affiliation(s)
- Sara P Herrero-Ruiz
- Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain
| | | | | | | | | | - Jesus Borbujo
- Department of Dermatology, Hospital Universitario de Fuenlabrada, Madrid, Spain
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33
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Berben JA, Miseré RML, van der Hulst RRWJ. The influence of personality on patient-reported outcomes in women undergoing implant-based breast reconstruction. J Plast Reconstr Aesthet Surg 2023; 87:303-309. [PMID: 37925919 DOI: 10.1016/j.bjps.2023.10.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 09/15/2023] [Accepted: 10/07/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Despite the lack of hard evidence for causality, some women attribute their systemic complaints to their silicone breast implants. Personality and psychological distress are associated with the development of medically unexplained symptoms. It could be hypothesized that these psychological factors are related to the development of breast implant illness (BII). In a previous study, we found a relationship between personality traits and BII-related complaints in patients with cosmetic breast implants. This association may also exist in patients with implant-based breast reconstruction. OBJECTIVES This cross-sectional study evaluated the association between personality, self-reported health complaints, and health- and breast-related quality of life (QoL) in women with implant-based breast reconstruction. METHODS Women who underwent breast reconstruction between January 2015 and December 2018 in either the Maastricht University Medical Center or Zuyderland Medical Center were invited to participate in this study. Participants were asked to complete a physical complaint score form and the BREAST-Q, SF-36, and EPQ-RSS questionnaires through an online survey. The association between outcomes was analyzed with multivariate linear regression. RESULTS A total of 118 women completed the questionnaires. Social desirability and extroversion were predominant personality traits. Neuroticism levels were comparable with normative data. Neuroticism correlated significantly with health status and breast-related QoL. Health-related QoL had the strongest correlation with neuroticism (β = -2.93, β = -3.41, p < 0.001). CONCLUSION This study suggests that personality, and neuroticism in particular, may contribute to the development of medically unexplained complaints in women with implant-based reconstruction. The influence of personality on BII needs to be further investigated in large prospective studies.
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Affiliation(s)
- Juliënne A Berben
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, Maastricht, the Netherlands.
| | - Renée M L Miseré
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - René R W J van der Hulst
- Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, Maastricht, the Netherlands
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Chatzikalil E, Kattamis A, Diamantopoulos P, Solomou EE. New-onset aplastic anemia after SARS-CoV-2 vaccination. Int J Hematol 2023; 118:667-681. [PMID: 37768509 DOI: 10.1007/s12185-023-03666-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/02/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023]
Abstract
Aplastic anemia (AA) is a rare autoimmune disease. Drugs, viruses, and radiation are among the most common etiologic factors, and most cases have immune pathophysiology. SARS-CoV-2 vaccines have been linked with rare side effects, including cases of acquired aplastic anemia. Here we review all the reported cases of new-onset AA after SARS-CoV-2 vaccination, and discuss their clinical characteristics and management. 18 patients in these case reports had a median age of 58 years. The time from vaccination to onset of aplastic anemia ranged from 1 day to 7 months, with a median of 2.5 weeks. Seventeen patients were diagnosed with severe or very severe aplastic anemia post-vaccination and all patients received standard treatments for acquired aplastic anemia. Seventeen patients achieved a complete or partial response and only 1 patient died. Aplastic anemia can be considered a very rare SARS-CoV-2 vaccine-related adverse event, although a causative relationship has not been proven. Reporting cases of such uncommon post-vaccination events could help clinicians to consider aplastic anemia when pancytopenia is observed after vaccination. The benefits of SARS-Cov-2 vaccination are established, and reports of rare events serve only to increase awareness in daily clinical practice.
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Affiliation(s)
- Elena Chatzikalil
- Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Antonis Kattamis
- Department of Pediatrics, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Panagiotis Diamantopoulos
- First Department of Internal Medicine, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Elena E Solomou
- Internal Medicine-Hematology, University of Patras Medical School, 26500, Rion, Greece.
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35
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McGuire PA, Glicksman C, McCarthy C, Spiegel A. Separating Myth from Reality in Breast Implants: An Overview of 30 Years of Experience. Plast Reconstr Surg 2023; 152:801e-807e. [PMID: 37010472 DOI: 10.1097/prs.0000000000010488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
SUMMARY The purpose of this article is to review the pivotal events in the history of breast implants in the United States, including the events leading to the U.S. Food and Drug Administration moratorium on the use of silicone gel implants and subsequent approval; the emergence of breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL); and persistent concerns about an association between breast implants, autoimmune disease, and systemic symptoms. This article reviews the medical literature to outline our current knowledge on BIA-ALCL; offers recommendations for diagnosis and management of symptomatic and asymptomatic patients with textured implants; and reviews the science of potential associations of implants with autoimmune and systemic symptoms. The authors hope to help patients separate myths from reality and make educated decisions on having breast implants placed or removed.
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Affiliation(s)
| | | | - Colleen McCarthy
- the Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Aldona Spiegel
- The Center for Breast Restoration, Weill Cornell Medical School, Houston Methodist Academic Institute, and Division of Surgical Innovation, Houston Methodist Hospital
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36
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Singhal V, Gupta S. Post-COVID-19 Vaccination and Thyrotoxicosis (ASIA Syndrome): Single-Centre Experience from India with Review of Literature. Indian J Endocrinol Metab 2023; 27:524-529. [PMID: 38371178 PMCID: PMC10871005 DOI: 10.4103/ijem.ijem_202_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/15/2023] [Accepted: 11/04/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction Thyrotoxicosis is not uncommon after immunization. It is known as 'autoimmune/autoinflammatory syndrome by adjuvants (ASIA syndrome)' and is caused by immunological reaction to adjuvants. However, there is insufficient information on thyrotoxicosis after COVID-19 vaccination in the Indian subcontinent. Aims/Objectives To investigate the spectrum of thyrotoxicosis after COVID-19 immunization. Settings and Design A single-centre retrospective study was conducted at a tertiary care academic institute in India. Materials and Methods We studied the clinical symptoms, biochemical markers, imaging characteristics and treatment of every patient who was diagnosed with thyrotoxicosis within 60 days of receiving the COVID-19 vaccine. Results Following COVID-19 vaccination, we diagnosed ten people (mean age 39.9 years, range 22-63 years) with thyrotoxicosis [Graves' disease (GD, n-6) and subacute thyroiditis (SAT, n-4)]. The typical duration for symptoms to appear was 2 to 60 days. The majority of patients (n-9) received the COVISHIELD™ vaccine, whereas only one received the COVAXIN® vaccine. After vaccination, two patients with GD developed mildly severe Graves' orbitopathy, with symptoms emerging two days and sixty days later, respectively. Anti-thyroid drugs (methimazole or carbimazole) were required for all GD patients. All SAT patients were treated conservatively with nonsteroidal anti-inflammatory medications and had positive outcomes. Conclusions SAT, GD and GO may occur as a manifestation of ASIA syndrome, following immunization with COVISHIELD™ and COVAXIN®. Despite the obvious benefits of the COVID-19 vaccine, clinicians should be aware of any potential autoimmune and inflammatory thyroid problems.
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Affiliation(s)
- Vaibhav Singhal
- Department of Endocrinology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sushil Gupta
- Department of Endocrinology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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37
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Yang Y, Xiong Y, Xu G. New insights of antineutrophil cytoplasmic antibody-associated vasculitis from the perspective of COVID-19 vaccination. Clin Exp Immunol 2023; 213:301-309. [PMID: 37074008 PMCID: PMC10570996 DOI: 10.1093/cei/uxad043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/16/2023] [Accepted: 04/12/2023] [Indexed: 04/20/2023] Open
Abstract
The occurrence of antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) has been reported since the coronavirus disease 2019 (COVID-19) vaccination, but whether there is a causal relationship or coincidence remains to be verified. We combined the term COVID-19 vaccination with each word of AAV to search for case reports and case series published in PubMed, EMBASE, and Web of Science databases before 13 March 2023. A total of 56 patients who developed AAV after COVID-19 vaccination were identified from 44 research centers. Of the 56 subjects, 43 (76.7%) were vaccinated with the mRNA vaccine, followed by the adenovirus vaccine (14.3%) and inactivated vaccine (9.0%) (P = 0.015). Compared with relapsed AAV, new-onset AAV patients had at least two other diseases previously (P < 0.001). Twenty-five (44.6%) patients presented symptoms after the first injection, and the medium onset time was 12 (1-77) days, while Twenty-eight (50.0%) patients developed symptoms after the second dose, and their medium period was 14 (1-60) days. Forty-four (78.5%) patients achieved remission after immunosuppressive agents, plasma exchange, and hemodialysis. One (1.8%) patient died from progressive respiratory failure and nine (16.1%) did not recover, leaving five patients permanently dependent on hemodialysis. Pathogenic ANCA may be activated by enhanced immune response and epitope spreading after COVID-19 vaccination and induced the occurrence of AAV, especially in genetically susceptible populations.
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Affiliation(s)
- Yang Yang
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Yi Xiong
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, PR China
| | - Gaosi Xu
- Department of Nephrology, The Second Affiliated Hospital of Nanchang University, Nanchang, PR China
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Armeni AK, Markantes GΚ, Stathopoulou A, Saltiki K, Zampakis P, Assimakopoulos SF, Michalaki MA. Thyroid Eye Disease as Initial Manifestation of Graves' Disease Following Viral Vector SARS-CoV-2 Vaccine: Report of a Case and Review of the Literature. Vaccines (Basel) 2023; 11:1574. [PMID: 37896977 PMCID: PMC10611184 DOI: 10.3390/vaccines11101574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/30/2023] [Accepted: 10/07/2023] [Indexed: 10/29/2023] Open
Abstract
COVID-19, a contagious disease caused by the novel coronavirus SARS-CoV-2, emerged in 2019 and quickly became a pandemic, infecting more than 700 million people worldwide. The disease incidence, morbidity and mortality rates have started to decline since the development of effective vaccines against the virus and the widespread immunization of the population. SARS-CoV-2 vaccines are associated with minor local or systemic adverse reactions, while serious adverse effects are rare. Thyroid-related disorders have been reported after vaccination for COVID-19, and Graves' disease (GD) is the second most common amongst them. Thyroid eye disease (TED), an extrathyroidal manifestation of GD, is rarely observed post-COVID-19 vaccination. All TED cases followed mRNA-based vaccinations, but two new onset mild TED cases post-viral vector vaccine (ChAdox1nCoV-19) have also been reported. We report the case of a 63-year-old woman who presented with new onset hyperthyroidism and moderate-to-severe and active TED 10 days after she received the first dose of a viral vector vaccine against SARS-CoV-2. This is the first case of moderate-to-severe TED after such a vaccine. Our patient was initially treated with intravenous glucocorticoids, and subsequently with intravenous rituximab, due to no response. The disease was rendered inactive after rituximab, but constant diplopia persisted, and the patient was referred for rehabilitative surgery.
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Affiliation(s)
- Anastasia K. Armeni
- Division of Endocrinology—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece; (A.K.A.); (G.K.M.); (A.S.)
| | - Georgios Κ. Markantes
- Division of Endocrinology—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece; (A.K.A.); (G.K.M.); (A.S.)
| | - Alexandra Stathopoulou
- Division of Endocrinology—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece; (A.K.A.); (G.K.M.); (A.S.)
| | - Katerina Saltiki
- Endocrine Unit, Department of Clinical Therapeutics, National and Kapodistrian University, 11528 Athens, Greece;
| | - Petros Zampakis
- Department of Radiology, University Hospital of Patras, 26504 Patras, Greece;
| | - Stelios F. Assimakopoulos
- Division of Infectious Diseases—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece;
| | - Marina A. Michalaki
- Division of Endocrinology—Department of Internal Medicine, School of Health Sciences, University of Patras, 26504 Patras, Greece; (A.K.A.); (G.K.M.); (A.S.)
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Zhu J, Liu J, Yan C, Wang D, Pan W. Trained immunity: a cutting edge approach for designing novel vaccines against parasitic diseases? Front Immunol 2023; 14:1252554. [PMID: 37868995 PMCID: PMC10587610 DOI: 10.3389/fimmu.2023.1252554] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023] Open
Abstract
The preventive situation of parasitosis, a global public health burden especially for developing countries, is not looking that good. Similar to other infections, vaccines would be the best choice for preventing and controlling parasitic infection. However, ideal antigenic molecules for vaccine development have not been identified so far, resulting from the complicated life history and enormous genomes of the parasites. Furthermore, the suppression or down-regulation of anti-infectious immunity mediated by the parasites or their derived molecules can compromise the effect of parasitic vaccines. Comparing the early immune profiles of several parasites in the permissive and non-permissive hosts, a robust innate immune response is proposed to be a critical event to eliminate the parasites. Therefore, enhancing innate immunity may be essential for designing novel and effective parasitic vaccines. The newly emerging trained immunity (also termed innate immune memory) has been increasingly recognized to provide a novel perspective for vaccine development targeting innate immunity. This article reviews the current status of parasitic vaccines and anti-infectious immunity, as well as the conception, characteristics, and mechanisms of trained immunity and its research progress in Parasitology, highlighting the possible consideration of trained immunity in designing novel vaccines against parasitic diseases.
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Affiliation(s)
- Jinhang Zhu
- Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Key Laboratory of Immunity and Metabolism, Department of Pathogen Biology and Immunology, Xuzhou Medical University, Xuzhou, Jiangsu, China
- The Second Clinical Medical College, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jiaxi Liu
- Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Key Laboratory of Immunity and Metabolism, Department of Pathogen Biology and Immunology, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Chao Yan
- Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Key Laboratory of Immunity and Metabolism, Department of Pathogen Biology and Immunology, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Dahui Wang
- Liangshan College (Li Shui) China, Lishui University, Lishui, Zhejiang, China
| | - Wei Pan
- Jiangsu Key Laboratory of Immunity and Metabolism, Jiangsu International Key Laboratory of Immunity and Metabolism, Department of Pathogen Biology and Immunology, Xuzhou Medical University, Xuzhou, Jiangsu, China
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Owczarczyk-Saczonek A, De Boulle K. Hyaluronic Acid Fillers and ASIA Syndrome: Case Studies. Clin Cosmet Investig Dermatol 2023; 16:2763-2771. [PMID: 37818199 PMCID: PMC10561616 DOI: 10.2147/ccid.s419716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/29/2023] [Indexed: 10/12/2023]
Abstract
A continuous increase in the popularity of esthetic procedures with the use of substances as HA has been observed for many years, which might be contributing to an increase in the number of adverse events. The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) can be provoked by hyaluronic acid (HA), which belongs to substances meeting the criteria of adjuvants. Mechanisms of the innate and acquired immune response are activated, leading to the dysregulation of T and B lymphocytes, inability to recognize one's own antigens, inflammation, damage to one's own tissues, and ultimately to autoimmunity. The objective of this article is to present a case-series study of patients who developed ASIA syndrome following HA injection after delayed inflammatory reaction (DIR) and emphasize the importance of the need for long-term monitoring after such the reaction. Lack of knowledge about ASIA can lead to delayed diagnosis and serious consequences for the patients. People with a history of immunization reactions, severe allergic reactions, individual predisposition to autoimmunity or family predisposition to autoimmunity and previous exposure to adjuvants require special attention and long-term follow-up. This applies primarily to cases of DIR after the using of bioimplants, especially with treatment resistance, as in our reported cases.
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Affiliation(s)
- Agnieszka Owczarczyk-Saczonek
- Department of Dermatology, Sexually Transmitted Diseases and Clinical Immunology, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
| | - Koenraad De Boulle
- Aalst Dermatology Clinic, Aalst Belgium and University College London, London, UK
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Beirão TMBDM, Samões B, Fonseca D, Rua C, Costa F, Vieira R, Aleixo J, Videira T, Ferreira C, Coelho H, Pinto P. Focal facial myositis-a paraneoplastic syndrome? Rheumatology (Oxford) 2023; 62:e297-e298. [PMID: 36944263 DOI: 10.1093/rheumatology/kead133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/08/2023] [Accepted: 03/13/2023] [Indexed: 03/23/2023] Open
Affiliation(s)
| | - Beatriz Samões
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Diogo Fonseca
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Catarina Rua
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Flávio Costa
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Romana Vieira
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Joana Aleixo
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Taciana Videira
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Cristina Ferreira
- Hematology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Henrique Coelho
- Hematology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
| | - Patrícia Pinto
- Rheumatology Department, Centro Hospitalar de Vila Nova de Gaia e Espinho, Vila Nova de Gaia, Portugal
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Izumi T, Takahashi H, Takahashi H. Anti-GAD antibody-positive fulminant type 1 diabetes developed following SARS-CoV-2 vaccination. Diabetol Int 2023; 14:422-426. [PMID: 37781472 PMCID: PMC10533421 DOI: 10.1007/s13340-023-00648-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 07/05/2023] [Indexed: 10/03/2023]
Abstract
Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been used worldwide since the 2020 coronavirus pandemic. However, several negative side-effects of these vaccines have been reported. Herein, we present a case of a patient with fulminant type 1 diabetes that developed shortly after administration of the SARS-CoV-2 vaccine. A 47-year-old man with no medical history presented with hyperglycemia-related symptoms shortly after receiving the third messenger ribonucleic acid SARS-CoV-2 vaccine. Based on hyperglycemia, diabetic ketoacidosis at onset, relatively low hemoglobin A1c levels, and complete depletion of endogenous insulin secretion, the patient was diagnosed with fulminant type 1 diabetes and insulin therapy was initiated. Through human leukocyte antigen genotyping, the disease-susceptible alleles for type 1 diabetes, DRB1*04:05 and DQB1*04:01, were identified. The patient tested positive for serum anti-glutamic acid decarboxylase antibodies, which are normally negative for fulminant type 1 diabetes, implying that immunomodulation triggered by SARS-CoV-2 vaccination influenced the onset of type 1 diabetes.
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Affiliation(s)
- Tomohito Izumi
- Division of Diabetes and Metabolism, Sendai City Hospital, 1-1-1 Asutonagamachi, Taihaku-Ku, Sendai, Miyagi 982-8502 Japan
| | - Hironobu Takahashi
- Division of Diabetes and Metabolism, Sendai City Hospital, 1-1-1 Asutonagamachi, Taihaku-Ku, Sendai, Miyagi 982-8502 Japan
| | - Hironori Takahashi
- Division of Diabetes and Metabolism, Sendai City Hospital, 1-1-1 Asutonagamachi, Taihaku-Ku, Sendai, Miyagi 982-8502 Japan
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43
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Markus E, Bel-Ange A, Benbassat C, Steinschneider M, Koren R. Short- and long-term outcomes of patients with hyper or hypothyroidism following COVID vaccine. J Investig Med 2023; 71:700-706. [PMID: 37199279 DOI: 10.1177/10815589231173876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Since the beginning of the wide-scale anti-Coronavirus disease 2019 (COVID-19) vaccination program, sporadic cases of thyroid disease following vaccination have been reported. We describe 19 consecutive cases of COVID vaccine-related thyroid disease. Medical records were reviewed for 9 patients with Graves' disease (GD) and 10 with Thyroiditis, all of whom were diagnosed following COVID-19 vaccination. In the GD group, the median age was 45.5 years, female/male(F/M) ratio 5:4, thyroid-stimulating immunoglobulins were elevated in seven patients. The median time from vaccination to diagnosis was 3 months. Methimazole treatment was given to all but one patient. At a median follow-up of 8.5 months from vaccination, three patients were still on methimazole, five went into remission (data were missing for one). In the Thyroiditis group, the median age was 47 years, the F/M ratio 7:3. Thyroiditis was diagnosed after the first, second, and third doses in one, two, and seven patients, respectively. The median time from vaccination to diagnosis was 2 months. TPO antibodies were positive in three patients. All patients were euthyroid off medication at the last visit. Six patients were diagnosed in the hypothyroid phase at 2.5 months from vaccination. Four resolved spontaneously at 3, 6, 4, and 8 months; the other two were treated with thyroxine at 1.5 and 2 months from vaccination and remained on treatment at their last visit, at 11.5 and 8.5 months, respectively. Thyroid disease should be included among possible complications of COVID-19 vaccine and either a late onset or delayed diagnosis should be considered.
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Affiliation(s)
- Efrat Markus
- Endocrine Institute, Shamir medical center, Zerifin, Israel
| | - Anat Bel-Ange
- Endocrine Institute, Shamir medical center, Zerifin, Israel
| | - Carlos Benbassat
- Endocrine Institute, Shamir medical center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Miriam Steinschneider
- Endocrine Institute, Shamir medical center, Zerifin, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Koren
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Internal Medicine A, Shamir Medical Center, Zerifin, Israel
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44
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Batman A, Yazıcı D, Dikbaş O, Ağbaht K, Saygılı ES, Demirci İ, Bursa N, Ayas G, Anıl C, Cesur M, Korkmaz FN, Bahçecioglu AB, Çorapçıoğlu D, Erdoğan MF, Bostan H, Calapkulu M, Hepşen S, Uçan B, Çakal E, Güler BY, Haymana C, İpekçi SH, Aydın S, Sezer H, Özışık S, Deyneli O, Alagöl F, Tanakol R, Eroğlu M, Mutlu Ü, Hacışahinoğulları H, Üzüm AK, Demir C, Koç G, Fırat SN, Omma T, İnce N, Polat ŞB, Topaloğlu O, Aydın C, Çakır B, Bahadır ÇT, Güven M, Sözen M, Selek A, Cantürk Z, Çetinarslan B, Aydemir M, Taşkaldıran I, Bozkuş Y, İyidir ÖT, Haydardedeoğlu FE, Basmaz SE, Ünal MÇ, Demir T, Oğuz A, Çelik Ö, Yilmaz M, Cimsir A, Kayıhan S, Uc ZA, Tekin S, Topaloğlu Ö, Saydam BÖ, Ünsal YA, Özer Ö, Yorulmaz G, Uğur K, Çakır SD, Aşık M, Unubol M, Genc S, Andac B, Okur M, Dogan O, Karakiliç E, Kocabas GU, Kirac CO, Cansu GB, Uygur MM, Pekkolay Z, Öztürk S, Güngüneş A, Gürkan E, Keskin L, Çağlayan K, Günay YE, İmre E, Şener SY, Kalkan AT, Gök DE, Şahin M. Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study. J Clin Endocrinol Metab 2023; 108:e1013-e1026. [PMID: 37186260 DOI: 10.1210/clinem/dgad235] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023]
Abstract
CONTEXT The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. METHODS This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19-related SAT (Cov-SAT), SARS-CoV-2 vaccine-related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. RESULTS Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. CONCLUSION Since there is no difference in terms of follow-up parameters and outcomes, COVID-19- and SARS-CoV-2 vaccine-related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism.
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Affiliation(s)
- Adnan Batman
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Dilek Yazıcı
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Oğuz Dikbaş
- Department of Endocrinology and Metabolism, Giresun University School of Medicine, 28200 Giresun, Turkey
| | - Kemal Ağbaht
- Department of Endocrinology and Metabolism, Defne Hospital, 31030 Hatay, Turkey
| | - Emre Sedar Saygılı
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, 17020 Canakkale, Turkey
| | - İbrahim Demirci
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Nurbanu Bursa
- Department of Statistics Beytepe, Hacettepe University, 06230 Ankara, Turkey
| | - Görkem Ayas
- School of Medicine, Koc University, 34450 Istanbul, Turkey
| | - Cüneyd Anıl
- Department of Endocrinology and Metabolic Diseases, Güven Hospital, 06540 Ankara, Turkey
| | - Mustafa Cesur
- Department of Endocrinology and Metabolic Diseases, Güven Hospital, 06540 Ankara, Turkey
| | - Fatma Nur Korkmaz
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Adile Begüm Bahçecioglu
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Demet Çorapçıoğlu
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Murat Faik Erdoğan
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
| | - Hayri Bostan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Murat Calapkulu
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Sema Hepşen
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Bekir Uçan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Erman Çakal
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Bağdagül Yüksel Güler
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Cem Haymana
- Department of Endocrinology and Metabolism, Gulhane Training and Research Hospital, University of Health Sciences Turkey, 06010 Ankara, Turkey
| | - Süleyman Hilmi İpekçi
- Department of Endocrinology, Hisar Intercontinental Hospital, 34768 Istanbul, Turkey
| | - Selami Aydın
- Department of Internal Medicine, Hisar Intercontinental Hospital, 34768 Istanbul, Turkey
| | - Havva Sezer
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Seçil Özışık
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Oğuzhan Deyneli
- Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, Koc University, 34010 Istanbul, Turkey
| | - Faruk Alagöl
- Department of Endocrinology and Metabolism, VKV Amerikan Hospital-Koç University School of Medicine, 34365 Istanbul, Turkey
| | - Refik Tanakol
- Department of Endocrinology and Metabolism, VKV Amerikan Hospital-Koç University School of Medicine, 34365 Istanbul, Turkey
| | - Mustafa Eroğlu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Balikesir University Faculty of Medicine, 10145 Balikesir, Turkey
| | - Ümmü Mutlu
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Hülya Hacışahinoğulları
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Ayşe Kubat Üzüm
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, 34093 Istanbul, Turkey
| | - Canan Demir
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Atilim University School of Medicine, 06830 Ankara, Turkey
| | - Gönül Koç
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Research Hospital, 06230 Ankara, Turkey
| | - Sevde Nur Fırat
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Research Hospital, 06230 Ankara, Turkey
| | - Tülay Omma
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Ankara Training and Reasearch Hospital, 06230 Ankara, Turkey
| | - Nurcan İnce
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Şefika Burçak Polat
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Oya Topaloğlu
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Cevdet Aydın
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Bekir Çakır
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University Faculty of Medicine, Ankara City Hospital, 06800 Ankara, Turkey
| | - Çiğdem Tura Bahadır
- Department of Endocrinology and Metabolism, Amasya University, School of Medicine, 05100 Amasya, Turkey
| | - Mehmet Güven
- Department of Endocrinology and Metabolism, Sirnak State Hospital, 73000 Sirnak, Turkey
| | - Mehmet Sözen
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Alev Selek
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Zeynep Cantürk
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Berrin Çetinarslan
- Department of Endocrinology and Metabolism, Kocaeli University, School of Medicine, 41000 Kocaeli, Turkey
| | - Mustafa Aydemir
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Akdeniz University, School of Medicine, 07050 Antalya, Turkey
| | - Işılay Taşkaldıran
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Yusuf Bozkuş
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Özlem Turhan İyidir
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 06790 Ankara, Turkey
| | - Filiz Ekşi Haydardedeoğlu
- Department of Endocrinology and Metabolism, Faculty of Medicine, Baskent University, 79097 Adana, Turkey
| | - Seda Erem Basmaz
- Department of Endocrinology and Metabolism, Kocaeli Derince Training and Research Hospital, 41900 Kocaeli, Turkey
| | - Mehmet Çağrı Ünal
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylul University, 35330 Izmir, Turkey
| | - Tevfik Demir
- Department of Endocrinology and Metabolism, Faculty of Medicine, Dokuz Eylul University, 35330 Izmir, Turkey
| | - Ayten Oğuz
- Department of Endocrinology and Metabolism, Faculty of Medicine, Biruni University, 34295 Istanbul, Turkey
| | - Özlem Çelik
- Department of Endocrinology and Metabolism, Faculty of Medicine, Acıbadem University, 34752 Istanbul, Turkey
| | - Merve Yilmaz
- Department of Endocrinology and Metabolism, Samsun State Hospital, 55060 Samsun, Turkey
| | - Aykut Cimsir
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Serdar Kayıhan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Diskapi Yildirim Beyazit Training and Research Hospital, 06110 Ankara, Turkey
| | - Ziynet Alphan Uc
- Department of Endocrinology and Metabolism, Usak University, Usak Training and Research Hospital, 64300 Usak, Turkey
| | - Sakin Tekin
- Department of Endocrinology and Metabolism, Faculty of Medicine, Zonguldak Bulent Ecevit University, 67100 Zonguldak, Turkey
| | - Ömercan Topaloğlu
- Department of Endocrinology and Metabolism, Faculty of Medicine, Zonguldak Bulent Ecevit University Obesity and Diabetes Practice and Research Center, 67100 Zonguldak, Turkey
| | - Başak Özgen Saydam
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Yenimahalle Training and Research Hospital, 06370 Ankara, Turkey
| | - Yasemin Aydoğan Ünsal
- Department of Endocrinology and Metabolism, Ankara Yildirim Beyazit University, Yenimahalle Training and Research Hospital, 06370 Ankara, Turkey
| | - Özge Özer
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, 26040 Eskisehir, Turkey
| | - Göknur Yorulmaz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Eskisehir Osmangazi University, 26040 Eskisehir, Turkey
| | - Kader Uğur
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Fırat University, 23119 Elazıg, Turkey
| | - Sezin Doğan Çakır
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Istanbul Taksim Training and Research Hospital, 34433 Istanbul, Turkey
| | - Mehmet Aşık
- Endocrinologist, Private Office, Bodrum, 48400 Mugla, Turkey
| | - Mustafa Unubol
- Department of Endocrinology and Metabolism, School of Medicine, Adnan Menderes University, 09100 Aydin, Turkey
| | - Selin Genc
- Department of Endocrinology and Metabolism, School of Medicine, Inonu University, 44280 Malatya, Turkey
| | - Burak Andac
- Department of Endocrinology and Metabolism, School of Medicine, Trakya University, 22130 Edirne, Turkey
| | - Mine Okur
- Department of Endocrinology and Metabolism, School of Medicine, Trakya University, 22130 Edirne, Turkey
| | - Ozlem Dogan
- Department of Endocrinology and Metabolism, University of Health Sciences Turkey, Haseki Training and Research Hospital, 34096 Istanbul, Turkey
| | - Ersen Karakiliç
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Faculty of Medicine, Canakkale Onsekiz Mart University, 17020 Canakkale, Turkey
| | - Gokcen Unal Kocabas
- Department of Endocrinology and Metabolism, Faculty of Medicine, Ege University, 35100 Izmir, Turkey
| | - Cem Onur Kirac
- Department of Endocrinology and Metabolism, Kahramanmaras Necip Fazil City Hospital, 46050 Kahramanmaras, Turkey
| | - Güven Barış Cansu
- Department of Endocrinology and Metabolism, School of Medicine, Kutahya University of Health Sciences, 43100 Kutahya, Turkey
| | - Meliha Melin Uygur
- Department of Endocrinology and Metabolism, School of Medicine, Marmara University, Pendik Training and Research Hospital, 34899 Istanbul, Turkey
| | - Zafer Pekkolay
- Department of Endocrinology and Metabolism, School of Medicine, Dicle University, 21100 Diyarbakir, Turkey
| | - Sadettin Öztürk
- Department of Endocrinology and Metabolism, School of Medicine, Gaziantep University, 27850 Gaziantep, Turkey
| | - Aşkın Güngüneş
- Department of Endocrinology and Metabolism, School of Medicine, Kırıkkale University, 71300 Kırıkkale, Turkey
| | - Eren Gürkan
- Department of Endocrinology and Metabolism, School of Medicine, Hatay Mustafa Kemal University, 31001 Hatay, Turkey
| | - Lezzan Keskin
- Department of Endocrinology and Metabolism, School of Medicine, Malatya Turgut Ozal University, Malatya Training and Research Hospital, 44000 Malatya, Turkey
| | - Kenan Çağlayan
- Department of Endocrinology and Metabolism, School of Medicine, Baskent University Istanbul Hospital, 34662 Istanbul, Turkey
| | - Yasemin Emur Günay
- Department of Endocrinology and Metabolism, School of Medicine, Karadeniz Technical University, 61080 Trabzon, Turkey
| | - Eren İmre
- Department of Endocrinology and Metabolism, Dr Ersin Arslan Education and Research Hospital, 27010 Gaziantep, Turkey
| | - Selcuk Yusuf Şener
- Department of Endocrinology and Metabolism, Pendik Medikalpark Hospital, 34899 Istanbul, Turkey
| | - Ahmet Toygar Kalkan
- Department of Endocrinology and Metabolism, Kastamonu Research and Training Hospital, 37150 Kastamonu, Turkey
| | - Deniz Engin Gök
- Department of Endocrinology and Metabolism, Lokman Hekim Hospital, 06700 Ankara, Turkey
| | - Mustafa Şahin
- Department of Endocrinology and Metabolism, Ankara University, School of Medicine, 06050 Ankara, Turkey
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Mathew M, John SB, Sebastian J, Ravi MD. COVID-19 vaccine triggered autoimmune hepatitis: case report. Eur J Hosp Pharm 2023; 30:e27. [PMID: 36207131 PMCID: PMC10447947 DOI: 10.1136/ejhpharm-2022-003485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/12/2022] [Indexed: 11/07/2022] Open
Abstract
Autoimmune hepatitis (AIH) is a non-contagious, chronic, inflammatory autoimmune disease in which one's own immune system attacks healthy, normal hepatic cells. The exact cause of AIH is unknown; however, the combination of genetic, environmental (eg, drugs and natural infection) and immunological factors may lead to AIH. AIH may also be potentiated with the use of vaccines: this case reports one such event following immunisation, along with 1 year of follow-up. A female patient in her late 20s presented to the hospital with yellowish discolouration of eyes, urine and stools. Her medical history revealed that she had been vaccinated with the first dose of a COVID-19 vaccine 10 days earlier. She had a history of asymptomatic COVID-19 infection 3 months ago and a history of chronic analgesic consumption for migraine. She was diagnosed as having AIH through extensive clinical and laboratory workup. This case may be an immediate enhancement of a hidden autoimmune disorder triggered by the vaccination. This adverse event following immunisation has an adequate temporal relationship with her COVID-19 vaccine. The causality can be categorised as 'indeterminate' and may be considered as a potential signal following COVID-19 vaccination.
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Affiliation(s)
- Merrin Mathew
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Sheba Baby John
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
| | - Juny Sebastian
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
- Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, UAE
| | - Mandyam Dhati Ravi
- Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
- Department of Pediatrics, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru, Karnataka, India
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Ioppolo L, Amenta A, Alessandri-Bonetti M, Borelli F, Calapai M, Veronesi P, De Lorenzi F. One-step Glandular Reconstruction after Breast Implant Removal: Technical Refinements and Grafting of the Inferior Dermoglandular Flap. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5247. [PMID: 37691704 PMCID: PMC10489352 DOI: 10.1097/gox.0000000000005247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/18/2023] [Indexed: 09/12/2023]
Abstract
The number of breast implant removal procedures are rising. Among the reasons why patients seek breast implant removal, the autoimmune/inflammatory syndrome induced by adjuvants (ASIA), also named breast implant illness, is increasingly common. ASIA is an entity that incorporates diverse autoimmune conditions induced by the exposure to various adjuvants, including silicone, and it is characterized by systemic symptoms reminiscent of autoimmune disorders. Implant removal has the most effective treatment for ASIA. We describe a technique for glandular cone reconstruction after complete capsulectomy and implant removal. It combines an inverted-T superomedial pedicled mastopexy with fat grafting of the breast quadrants and of the inferior dermoglandular flap in two patients affected by ASIA. Implant removal allowed symptom resolution in both patients at 10 and 12 months follow-up. Both patients were satisfied with the aesthetic outcome after implant removal in terms of breast softness, projection, and volume. Our technique is easy, reproducible, and allowed for restoration of breast contour, volume, and shape after implant removal. Although initially conceived in patients with ASIA, this technique can be used for patients seeking implant removal for any indication.
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Affiliation(s)
- Leonardo Ioppolo
- From the Department of Plastic Surgery, Marrelli Hospital, Crotone, Italy
| | - Antonio Amenta
- From the Department of Plastic Surgery, Marrelli Hospital, Crotone, Italy
| | - Mario Alessandri-Bonetti
- Department of Plastic Surgery, University of Milan, Milan, Italy
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
| | - Francesco Borelli
- Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Marco Calapai
- Department of Breast Surgery, Ospedale San Vincenzo, Taormina, Italy
| | - Paolo Veronesi
- Department of Plastic Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pa
- Department of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy
| | - Francesca De Lorenzi
- Department of Plastic and Reconstructive Surgery, European Institute of Oncology, IRCCS, Milan, Italy
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Fukihara J, Kondoh Y. COVID-19 and interstitial lung diseases: A multifaceted look at the relationship between the two diseases. Respir Investig 2023; 61:601-617. [PMID: 37429073 PMCID: PMC10281233 DOI: 10.1016/j.resinv.2023.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/09/2023] [Accepted: 05/22/2023] [Indexed: 07/12/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although it has been a fatal disease for many patients, the development of treatment strategies and vaccines have progressed over the past 3 years, and our society has become able to accept COVID-19 as a manageable common disease. However, as COVID-19 sometimes causes pneumonia, post-COVID pulmonary fibrosis (PCPF), and worsening of preexisting interstitial lung diseases (ILDs), it is still a concern for pulmonary physicians. In this review, we have selected several topics regarding the relationships between ILDs and COVID-19. The pathogenesis of COVID-19-induced ILD is currently assumed based mainly on the evidence of other ILDs and has not been well elucidated specifically in the context of COVID-19. We have summarized what has been clarified to date and constructed a coherent story about the establishment and progress of the disease. We have also reviewed clinical information regarding ILDs newly induced or worsened by COVID-19 or anti-SARS-CoV-2 vaccines. Inflammatory and profibrotic responses induced by COVID-19 or vaccines have been thought to be a risk for de novo induction or worsening of ILDs, and this has been supported by the evidence obtained through clinical experience over the past 3 years. Although COVID-19 has become a mild disease in most cases, it is still worth looking back on the above-reviewed information to broaden our perspectives regarding the relationship between viral infection and ILD. As a representative etiology for severe viral pneumonia, further studies in this area are expected.
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Affiliation(s)
- Jun Fukihara
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan
| | - Yasuhiro Kondoh
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi, 489-8642, Japan.
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Zolotykh VG, Gvozdetckii AN, Maevskaya VA, Utekhin VJ, Churilov LP, Shoenfeld Y, Yablonskiy PK. Silicone prosthetics and anti-thyroid autoimmunity. Langenbecks Arch Surg 2023; 408:312. [PMID: 37581699 DOI: 10.1007/s00423-023-03030-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 07/24/2023] [Indexed: 08/16/2023]
Abstract
INTRODUCTION In esthetic surgery, the use of silicone implants is a topic of hot discussion. MATERIAL AND METHODS An analysis of 119 esthetic surgical interventions on the mammary gland was performed. A study of the immune and endocrine parameters after mammoplasty was carried out. RESULTS The phenomenon of an increase in the levels of autoantibodies to the TSH receptor was revealed. The phenomenon of pre-operative growth of prolactin and TSH levels has been confirmed. An increase in thyroid autoimmunity after silicone mammoplasty is interpreted as a result of a silicone adjuvant action. An increase in the incidence of ASIA syndrome in patients who underwent breast surgery was registered. However, it was observed in both patients with silicone and non-silicone breast surgeries and therefore could not be solely explained by the use of silicone. Within 12 months following silicone mammoplasty, the patients with an increase of anti-TSH receptor autoimmunity nevertheless did not show any clinical and laboratory signs of overt thyroid disease, thus staying in a pre-nosological state. PRACTICAL RECOMMENDATIONS: Based on these results, we recommend the following for esthetic surgery: (a) all patients planned for silicone implant surgery should be examined for autoantibodies to the TSH receptor and (b) patients who have undergone breast endoprosthesis, starting 6 months after the operation, need long-term follow-up for thyroid status with mandatory testing for the level of these autoantibodies.
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Affiliation(s)
- V G Zolotykh
- St. Petersburg State Budgetary Healthcare Institution "City Hospital No. 40 of the Kurortny district", 9, Borisova ul., St. Petersburg, Russian Federation, 197706.
- St. Petersburg State University, 7-9, Universitetskaya nab., St. Petersburg, Russian Federation, 199034.
| | - A N Gvozdetckii
- North-Western State Medical University named after I.I. Mechnikov, 41, Kirochnaya ul., St. Petersburg, Russian Federation, 191015
| | - V A Maevskaya
- Saint Petersburg State University of Economics - UNECON, 30-32, Griboedov canal nab., St. Petersburg, Russian Federation, 191023
| | - V J Utekhin
- St. Petersburg State University, 7-9, Universitetskaya nab., St. Petersburg, Russian Federation, 199034
- Saint Petersburg State Pediatric Medical University, 2, Litovskaya ul, St. Petersburg, Russian Federation, 194100
| | - L P Churilov
- St. Petersburg State University, 7-9, Universitetskaya nab., St. Petersburg, Russian Federation, 199034
- St. Petersburg Research Institute of Phthisiopulmonology, Health Ministry of Russia, 2-4, Ligovskiy pr., St. Petersburg, Russian Federation, 191036
| | - Y Shoenfeld
- St. Petersburg State University, 7-9, Universitetskaya nab., St. Petersburg, Russian Federation, 199034
- Ariel University, 65, Ramat HaGolan St., 4077625, Ariel, Israel
| | - P K Yablonskiy
- St. Petersburg State University, 7-9, Universitetskaya nab., St. Petersburg, Russian Federation, 199034
- St. Petersburg Research Institute of Phthisiopulmonology, Health Ministry of Russia, 2-4, Ligovskiy pr., St. Petersburg, Russian Federation, 191036
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Ryad R, Osman A, Almusa A, Gerges P, Sumbul-Yuksel B. Dermatomyositis Flare-Up Following the SARS-CoV-2 Vaccine: A Case Report and Literature Review. Cureus 2023; 15:e44324. [PMID: 37779754 PMCID: PMC10538353 DOI: 10.7759/cureus.44324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2023] [Indexed: 10/03/2023] Open
Abstract
Dermatomyositis is a rare auto-immune inflammatory myopathy of unknown etiology. Several environmental factors, including vaccines, have been identified as potential triggers in genetically susceptible individuals. Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the development of vaccines (mRNA and vector-based) has been the most effective tool in reducing the incidence, hospitalization rates, and mortality of COVID-19. However, among individuals with immune dysregulation and auto-immune conditions, unique challenges may arise with immune stimulation. We present a case of a dermatomyositis flare-up following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. A 40-year-old Hispanic female presented to the emergency department with shortness of breath, muscle pain and weakness, and skin rash for two days. She had been recently diagnosed with dermatomyositis six months prior based on clinical presentation, laboratory investigations, and characteristic muscle biopsy findings. She had been on treatment with mycophenolate mofetil, prednisone, and hydroxychloroquine since. She reported receiving the second dose of the BNT162b2 COVID-19 vaccine one day prior to the onset of symptoms. Physical examination revealed erythematous plaques over her cheeks, upper chest, and arms, in addition to Gottron papules on her hands. She had reduced proximal muscle strength and scattered dry crackles bilaterally on lung auscultation. Her laboratory investigations were remarkable for elevated erythrocyte sedimentation rate, C-reactive peptide, creatinine kinase, and troponin T. The SARS- CoV-2 PCR test was negative. CT scan of the chest showed evidence of pneumonitis. A diagnosis of the dermatomyositis flare-up potentially secondary to the SARS-CoV-2 BNT162b2 vaccine was established. The patient was admitted and treated with pulse steroids and intravenous immunoglobulin. She responded well to therapy and was discharged home four days later. There have been several reports of a new onset of dermatomyositis following the SARS-CoV-2 vaccine which highlights the need for further large-scale studies to estimate the prevalence of such adverse effects. The benefits of the SARS-CoV-2 vaccine outweigh the risks even among patients with auto-immune and rheumatologic conditions; however, it is important for clinicians to recognize the possibility of occurrence of such events in order to manage patients appropriately.
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Affiliation(s)
- Robert Ryad
- Internal Medicine, AdventHealth Orlando, Orlando, USA
| | - Alsayed Osman
- Internal Medicine, AdventHealth Orlando, Orlando , USA
| | - Ahmad Almusa
- Internal Medicine, AdventHealth Orlando, Orlando , USA
| | - Peter Gerges
- Internal Medicine, AdventHealth Orlando, Orlando, USA
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Hoteit B, Pinsolle V, Delgove A, Dannepond A, Michot A. [Siliconosis with rheumatoid polyarthritis following a breast implant rupture: Case report and literature review]. ANN CHIR PLAST ESTH 2023; 68:368-372. [PMID: 36966097 DOI: 10.1016/j.anplas.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/26/2023] [Accepted: 03/05/2023] [Indexed: 03/27/2023]
Abstract
Breast implant rupture is a common complication in plastic surgery, with various clinical presentations, due to silicone migration. In this article, we present the case of a patient with ruptured silicone implants, who developed siliconosis with rheumatoid polyarthritis, and evolved favourably after explantation surgery. The physiopathology of this disease, and the implication of silicone migration are still controversial, and yet to be confirmed.
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Affiliation(s)
- B Hoteit
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, centre Francois-Xavier-Michelet, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France.
| | - V Pinsolle
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, centre Francois-Xavier-Michelet, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - A Delgove
- Service de chirurgie plastique, reconstructrice et esthétique, chirurgie de la main, centre Francois-Xavier-Michelet, CHU de Bordeaux, place Amélie-Raba-Léon, 33000 Bordeaux, France
| | - A Dannepond
- Service de chirurgie oncologique, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux, France
| | - A Michot
- Service de chirurgie oncologique, institut Bergonié, 229, cours de l'Argonne, 33076 Bordeaux, France
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