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Jarrot PA, Mirouse A, Ottaviani S, Cadiou S, Salmon JH, Liozon E, Parreau S, Michaud M, Terrier B, Gavand PE, Trefond L, Lavoiepierre V, Keraen J, Rekassa D, Bouldoires B, Weitten T, Roche D, Poulet A, Charpin C, Grobost V, Hermet M, Pallure M, Wackenheim C, Karkowski L, Grumet P, Rogier T, Belkefi N, Pestre V, Broquet E, Leurs A, Gautier S, Gras V, Gilet P, Holubar J, Sivova N, Schleinitz N, Durand JM, Castel B, Petrier A, Arcani R, Gramont B, Guilpain P, Lepidi H, Weiller PJ, Micallef J, Saadoun D, Kaplanski G. Polymyalgia rheumatica and giant cell arteritis following COVID-19 vaccination: Results from a nationwide survey. Hum Vaccin Immunother 2024; 20:2334084. [PMID: 38563792 PMCID: PMC10989707 DOI: 10.1080/21645515.2024.2334084] [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: 01/17/2024] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
We conducted a national in-depth analysis including pharmacovigilance reports and clinical study to assess the reporting rate (RR) and to determine the clinical profile of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) in COVID-19-vaccinated individuals. First, based on the French pharmacovigilance database, we estimated the RR of PMR and GCA cases in individuals aged over 50 who developed their initial symptoms within one month of receiving the BNT162b2 mRNA, mRNA-1273, ChAdOx1 nCoV-19, and Ad26.COV2.S vaccines. We then conducted a nationwide survey to gather clinical profiles, therapeutic management, and follow-up data from individuals registered in the pharmacovigilance study. A total of 70 854 684 COVID-19 vaccine doses were administered to 25 260 485 adults, among which, 179 cases of PMR (RR 7. 1 cases/1 000 000 persons) and 54 cases of GCA (RR 2. 1 cases/1 000 000 persons) have been reported. The nationwide survey allowed the characterization of 60 PMR and 35 GCA cases. Median time to the onset of first symptoms was 10 (range 2-30) and 7 (range 2-25) days for PMR and GCA, respectively. Phenotype, GCA-related ischemic complications and -large vessel vasculitis as well as therapeutic management and follow-up seemed similar according to the number of vaccine shots received and when compared to the literature data of unvaccinated population. Although rare, the short time between immunization and the onset of first symptoms of PMR and GCA suggests a temporal association. Physician should be aware of this potential vaccine-related phenomenon.
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Affiliation(s)
- Pierre-André Jarrot
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S1263, Aix-Marseille University, Marseille, France
| | - Adrien Mirouse
- Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l’Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France
- INSERM, UMR_S 959 Lab, Immunology, Immunotherapeutics, Paris, France
- DMU 3ID, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Sébastien Ottaviani
- Department of Rheumatology, DMU Locomotion, Hôpital Bichat-Claude Bernard, APHP, Université de Paris, Paris, France
| | - Simon Cadiou
- Department of Rheumatology, CHU de Rennes, Université de Rennes 1, Rennes, France
| | - Jean-Hugues Salmon
- Department of Rheumatology, Hôpital de La Maison Blanche, Université de Reims, Reims, France
| | - Eric Liozon
- Department of Internal Medicine, Hôpital Universitaire de Limoges, Limoges, France
| | - Simon Parreau
- Department of Internal Medicine, Hôpital Universitaire de Limoges, Limoges, France
| | - Martin Michaud
- Department of Internal Medicine, Clinique Saint-Exupery, Toulouse, France
| | - Benjamin Terrier
- National Referral Center for Rare Systemic Autoimmune Disease, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Centre, Université Paris Cité, Paris, France
| | | | - Ludovic Trefond
- Department of Internal Medicine, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Virginie Lavoiepierre
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jeremy Keraen
- Department of Internal Medicine, Hôpital de Cornouaille, Quimper, France
| | - Daniel Rekassa
- Department of Rehabilitation, Centre Thermal, Greoux Les Bains, France
| | | | - Thierry Weitten
- Department of Internal Medicine, Hôpital des Alpes du Sud, Gap, France
| | - Damien Roche
- Department of Rheumatology, Hôpital Saint-Joseph, Marseille, France
| | - Antoine Poulet
- Department of Internal Medicine, Hôpital Saint-Joseph, Marseille, France
| | - Caroline Charpin
- Department of Rheumatology, Hôpital Saint-Joseph, Marseille, France
| | - Vincent Grobost
- Department of Internal Medicine, Hôpital Estaing, Clermont-Ferrand, France
| | - Marion Hermet
- Department of Internal Medicine, Hôpital de Vichy, Vichy, France
| | - Magali Pallure
- Department of Rheumatology, Hôpital de Cannes Simone Veil, Cannes, France
| | - Chloe Wackenheim
- Department of Internal Medicine, Medipole Hôpital Privé, Villeurbanne, France
| | - Ludovic Karkowski
- Department of Internal Medicine, Hôpital d’Instruction des Armées Sainte-Anne, Toulon, France
| | - Pierre Grumet
- Department of Internal Medicine, Hôpital des Alpes du Sud, Gap, France
| | - Thomas Rogier
- Department of Internal Medicine and Systemic Disease, Hôpital François Mitterand, Dijon, France
| | - Nabil Belkefi
- Department of Internal Medicine, CH de Melun, Melun, France
| | - Vincent Pestre
- Department of Internal Medicine and Infectious Disease, CH d’Avignon, Avignon, France
| | | | - Amélie Leurs
- Department of Internal Medicine and Infectious Disease, CH de Dunkerque, Dunkerque, France
| | - Sophie Gautier
- Department of Pharmacology, centre régional de pharmacovigilance Nord Pas de Calais, CHRU de Lille, Lille, France
| | - Valérie Gras
- Department of Clinical Pharmacology, Centre régional de pharmacovigilance, service de pharmacologie clinique, CHU Amiens-Picardie, Amiens, France
| | - Pierre Gilet
- Regional Center of Pharmacovigilance, CHRU de Nancy, Hôpital Central, Nancy, France
| | - Jan Holubar
- Department of Internal Medicine, CHU de Nîmes, Nîmes, France
| | - Nadia Sivova
- Department of Internal Medicine, CH de Tourcoing, Tourcoing, France
| | - Nicolas Schleinitz
- Department of Internal Medicine, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Jean-Marc Durand
- Department of Internal Medicine, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Brice Castel
- Department of Internal Medicine, CH de Tarbes, Tarbes, France
| | | | - Robin Arcani
- Department of Internal Medicine and Therapeutics Department, Hôpital de La Timone, Marseille, France
| | - Baptiste Gramont
- Department of Internal Medicine, CHU de Saint-Etienne, Saint-Etienne, France
| | - Philippe Guilpain
- Department of Internal Medicine, CHU Saint-Eloi, Montpellier, France
| | - Hubert Lepidi
- Pathological Laboratory, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | | | - Joelle Micallef
- Department of Clinical Pharmacology and pharmacosurveillance, Regional Pharmacovigilance Center of Marseille, Hôpital de La Timone, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - David Saadoun
- Department of Internal Medicine and Clinical Immunology, Centre de Référence des Maladies Auto-Immunes Systémiques Rares, Centre de Référence des Maladies Auto-Inflammatoires et de l’Amylose inflammatoire (CEREMAIA), Sorbonne Universités, Paris, France
- INSERM, UMR_S 959 Lab, Immunology, Immunotherapeutics, Paris, France
- DMU 3ID, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
| | - Gilles Kaplanski
- Department of Internal Medicine and Clinical Immunology, Hôpital de La Conception, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Centre for Cardiovascular and Nutrition Research (C2VN), INRA 1260, INSERM UMR_S1263, Aix-Marseille University, Marseille, France
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Rimbert N, Retout A, Muraine M, Thorel D. [Acute orbital inflammation in VEXAS syndrome: Case report]. J Fr Ophtalmol 2024; 47:104128. [PMID: 38448312 DOI: 10.1016/j.jfo.2024.104128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/03/2023] [Indexed: 03/08/2024]
Affiliation(s)
- N Rimbert
- CHU de Rouen, 2, rue de Germont, 76000 Rouen, France.
| | - A Retout
- CHU de Rouen, 2, rue de Germont, 76000 Rouen, France
| | - M Muraine
- CHU de Rouen, 2, rue de Germont, 76000 Rouen, France
| | - D Thorel
- CHU de Rouen, 2, rue de Germont, 76000 Rouen, France
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Schifano N, Capogrosso P, Boeri L, Fallara G, Cakir OO, Castiglione F, Alnajjar HM, Muneer A, Deho' F, Schifano F, Montorsi F, Salonia A. Medications mostly associated with priapism events: assessment of the 2015-2020 Food and Drug Administration (FDA) pharmacovigilance database entries. Int J Impot Res 2024; 36:50-54. [PMID: 35597798 DOI: 10.1038/s41443-022-00583-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 04/25/2022] [Accepted: 05/03/2022] [Indexed: 11/09/2022]
Abstract
A range of drugs have a direct role in triggering ischaemic priapism. We aimed at identifying: a) which medications are associated with most priapism-reports; and, b) within these medications, comparing their potential to elicit priapism through a disproportionality analysis. The FDA Adverse Event Reporting System (FAERS) database was queried to identify those drugs associated the most with priapism reports over the last 5 years. Only those drugs being associated with a minimum of 30 priapism reports were considered. The Proportional Reporting Ratios (PRRs), and their 95% confidence intervals were computed. Out of the whole 2015-2020 database, 1233 priapism reports were identified, 933 of which (75.7%) were associated with 11 medications with a minimum of 30 priapism-reports each. Trazodone, olanzapine and tadalafil showed levels of disproportionate reporting, with a PRR of 9.04 (CI95%: 7.73-10.58), 1.55 (CI95%: 1.27-1.89), and 1.42 (CI95%: 1.10-1.43), respectively. Most (57.5%) of the reports associated with the phosphodiesterase type 5 inhibitors (PDE5Is) were related with concomitant priapism-eliciting drugs taken at the same time and/or inappropriate intake/excessive dosage. Patients taking trazodone and/or antipsychotics need to be aware of the priapism-risk; awareness among prescribers would help in reducing priapism-related detrimental sequelae; PDE5I-intake is not responsible for priapism by itself, when appropriate medical supervision is provided.
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Affiliation(s)
- Nicolò Schifano
- Università Vita-Salute San Raffaele, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Paolo Capogrosso
- ASST Sette Laghi-Circolo e Fondazione Macchi Hospital, Varese, Italy
| | - Luca Boeri
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
- Department of Urology, IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Giuseppe Fallara
- Università Vita-Salute San Raffaele, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Omer Onur Cakir
- Institute of Andrology, Department of Urology, University College London Hospitals NHS Trust, London, UK
- Division of Surgery and Interventional Science, UCL, London, UK
| | - Fabio Castiglione
- Institute of Andrology, Department of Urology, University College London Hospitals NHS Trust, London, UK
- Division of Surgery and Interventional Science, UCL, London, UK
| | - Hussain M Alnajjar
- Institute of Andrology, Department of Urology, University College London Hospitals NHS Trust, London, UK
- Division of Surgery and Interventional Science, UCL, London, UK
| | - Asif Muneer
- Institute of Andrology, Department of Urology, University College London Hospitals NHS Trust, London, UK
- Division of Surgery and Interventional Science, UCL, London, UK
| | - Federico Deho'
- ASST Sette Laghi-Circolo e Fondazione Macchi Hospital, Varese, Italy
| | - Fabrizio Schifano
- Psychopharmacology; Drug Misuse; and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, UK
| | - Francesco Montorsi
- Università Vita-Salute San Raffaele, Milan, Italy
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Salonia
- Università Vita-Salute San Raffaele, Milan, Italy.
- Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy.
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González-Guerra E, Conde Taboada A, Muñoz LC, Suarez Solís ML, López-Bran E, Sánchez Fructuoso AI. Influenza vaccine-induced leukocytoclastic vasculitis in a patient with a transplanted kidney. Nefrologia 2023; 43 Suppl 2:114-116. [PMID: 38216428 DOI: 10.1016/j.nefroe.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/25/2022] [Indexed: 01/14/2024] Open
Affiliation(s)
| | | | - Lucía Campos Muñoz
- Departamento de Dermatología, Hospital Clínico San Carlos, Madrid, Spain.
| | | | - Eduardo López-Bran
- Departamento de Dermatología, Hospital Clínico San Carlos, Madrid, Spain.
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Baldini S, Khattak A, Capogrosso P, Antonini G, Dehò F, Schifano F, Schifano N. The Possible Role of Prescribing Medications, Including Central Nervous System Drugs, in Contributing to Male-Factor Infertility (MFI): Assessment of the Food and Drug Administration (FDA) Pharmacovigilance Database. Brain Sci 2023; 13:1652. [PMID: 38137101 PMCID: PMC10741514 DOI: 10.3390/brainsci13121652] [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: 09/26/2023] [Revised: 11/21/2023] [Accepted: 11/23/2023] [Indexed: 12/24/2023] Open
Abstract
BACKGROUND A wide range of medications may have a possible role in the development of male-factor infertility (MFI), including various antineoplastic agents, testosterone/anabolic steroids, immunosuppressive drugs/immunomodulators, glucocorticosteroids, non-steroidal anti-inflammatory drugs, opiates, antiandrogenic drugs/5-alpha-reductase inhibitors, various antibiotics, antidepressants, antipsychotics, antiepileptic agents and others. We aimed at investigating this issue from a pharmacovigilance-based perspective. METHODS The Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database was queried to identify the drugs associated the most with MFI individual reports. Only those drugs being associated with more than 10 MFI reports were considered for the disproportionality analysis. Proportional Reporting Ratios (PRRs) and their confidence intervals were computed for all the drugs identified in this way in January 2023. Secondary, 'unmasking', dataset analyses were carried out as well. RESULTS Out of the whole database, 955 MFI reports were identified, 408 (42.7%) of which were associated with 20 medications, which had more than 10 reports each. Within this group, finasteride, testosterone, valproate, diethylstilbestrol, mechloretamine, verapamil, lovastatin and nifedipine showed significant levels of actual disproportionate reporting. Out of these, and before unmasking, the highest PRR values were identified for finasteride, diethylstilbestrol and mechloretamine, respectively, with values of 16.0 (12.7-20.3), 14.3 (9.1-22.4) and 58.7 (36.3-95.9). CONCLUSIONS A variety of several medications, a number of which were already supposed to be potentially linked with MFI based on the existing evidence, were associated with significant PRR levels for MFI in this analysis. A number of agents which were previously hypothesized to be associated with MFI were not represented in this analysis, suggesting that drug-induced MFI is likely under-reported to regulatory agencies. Reproductive medicine specialists should put more effort into the detection and reporting of these adverse drug reactions.
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Affiliation(s)
- Sara Baldini
- ASST Sette Laghi—Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy; (S.B.); (P.C.); (G.A.); (F.D.)
- Division of Urology, School of Medicine, University of Insubria, 21100 Varese, Italy
| | - Ahmed Khattak
- King’s College Hospital NHS Foundation Trust, London SE5 9RS, UK;
| | - Paolo Capogrosso
- ASST Sette Laghi—Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy; (S.B.); (P.C.); (G.A.); (F.D.)
| | - Gabriele Antonini
- ASST Sette Laghi—Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy; (S.B.); (P.C.); (G.A.); (F.D.)
- Antonini Urology, 00185 Rome, Italy
| | - Federico Dehò
- ASST Sette Laghi—Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy; (S.B.); (P.C.); (G.A.); (F.D.)
- Division of Urology, School of Medicine, University of Insubria, 21100 Varese, Italy
| | - Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK;
| | - Nicolò Schifano
- ASST Sette Laghi—Circolo e Fondazione Macchi Hospital, 21100 Varese, Italy; (S.B.); (P.C.); (G.A.); (F.D.)
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Fisher L, David P, Sobeh T, Liberman RB, Amital H. Susac syndrome following COVID-19 vaccination: a case-based review. Clin Rheumatol 2023; 42:1713-1717. [PMID: 36877303 PMCID: PMC9986653 DOI: 10.1007/s10067-023-06564-1] [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: 10/23/2022] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 03/07/2023]
Abstract
COVID-19 vaccine circulation approval was a turning point for the coronavirus pandemic. The current approved COVID-19 vaccines, including messenger ribonucleic acid (mRNA)-based and adenovirus vector-based vaccines, were shown to significantly reduce the disease mortality and severity, and its adverse reactions are mainly mild ones. However, few cases of autoimmune conditions, both flare-ups and new-onset, were described in association with these vaccines. Susac vasculitis (SaS) is a rare autoimmune disease characterized by the clinical triad of encephalopathy, visual disturbances, and sensorineural hearing loss. Its pathogenesis is still not fully understood but is believed to be related to autoimmune processes, including autoantibodies to anti-endothelial cells and cellular immune processes that lead to microvascular damage and, consequently, micro-occlusions of the cerebral, inner ear, and retinal vessels. It has been previously described following vaccination and, most recently, few cases following coronavirus vaccines. We here describe a case of a previously healthy 49-year-old man diagnosed with SaS 5 days following the first dose of the BNT162b2 COVID-19 vaccine.
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Affiliation(s)
- Lior Fisher
- Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel. .,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Paula David
- Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Tamer Sobeh
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Department of Diagnostic Imaging, Sheba Medical Center, Tel-Hashomer, Israel
| | - Roberta Bisker Liberman
- Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel.,Pontifical Catholic University of São Paulo, São Paulo, Brazil
| | - Howard Amital
- Department of Medicine B, Sheba Medical Center, Tel-Hashomer, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel
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Chomičienė A, Černiauskas K, Linauskienė K, Meškauskas R, Malinauskienė L. Two case reports of skin vasculitis following the COVID-19 immunization. Open Med (Wars) 2022; 17:1944-1948. [PMID: 36561846 PMCID: PMC9743192 DOI: 10.1515/med-2022-0608] [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: 05/09/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 12/14/2022] Open
Abstract
The coronavirus 2019 (COVID-19) disease is now responsible for one of the most challenging and concerning pandemics. Since December 2020, the world has had access to COVID-19 prophylaxis; thus, we encounter adverse events from vaccination more often due to the vast vaccination range. We present two case reports of difficult-to-treat skin vasculitis due to COVID-19 vaccination that were successfully treated in a tertiary-level university hospital. When encountering systemic treatment, resistant skin vasculitis plasmapheresis could be a choice of treatment.
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Affiliation(s)
- Anželika Chomičienė
- Vilnius University, Medical Faculty, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Department of Pulmonology and Allergology, Vilnius, Lithuania
| | - Kęstutis Černiauskas
- Vilnius University, Medical Faculty, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Department of Pulmonology and Allergology, Vilnius, Lithuania
| | - Kotryna Linauskienė
- Vilnius University, Medical Faculty, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Department of Pulmonology and Allergology, Vilnius, Lithuania,Vilnius University Hospital Santaros Klinikos, Department of Pulmonology and Allergology, Santariškių Str. 2, Vilnius LT-08661, Lithuania
| | - Raimundas Meškauskas
- Pathology Department, National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Laura Malinauskienė
- Vilnius University, Medical Faculty, Institute of Clinical Medicine, Clinic of Chest Diseases, Immunology and Allergology, Department of Pulmonology and Allergology, Vilnius, Lithuania
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Une artérite à cellules géantes dans les suites d’une vaccination anti-pneumococcique : premier cas décrit. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Chen Y, Li Y, Zhan T. A case report of possible concurrent vasculitis in vertebral bodies and partial transverse myelitis following COVID-19 vaccination. Medicine (Baltimore) 2022; 101:e30814. [PMID: 36181106 PMCID: PMC9524522 DOI: 10.1097/md.0000000000030814] [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] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Cases with organ-specific and systemic vasculitis associated with corona virus disease 2019 (COVID-19) vaccination have been reported. However, acute partial transverse myelitis (APTM) is rare adverse events following received COVID-19 vaccines. To the best of our knowledge, there is no report on vaccine-associated APTM accompanied by possible concurrent vasculitis. Herein we present a case with possible concurrent spinal vasculitis and APTM following the second dose of inactivated COVID-19 vaccine. CASE SUMMARY A 33-year-old man presented with weakness of left lower limb and aberrant sensation of his left lower trunk and limb (from T9 level to toes) for 2 days following receipt of an inactivated COVID-19 vaccine. Remarkable demyelinating lesion at T7 spinal cord was showed by 3.0T magnetic resonance imaging (MRI) scan. Moreover, vertebral bodies of T3-T7 also presented high signal in T-2 weighted imaging (T2WI) accompanied by multiple sites of flowing void effect indicating possible vasculitis. Oligoclonal band was positive in cerebrospinal fluid (CSF) while it was negative in sera. Intravenous methylprednisolone (1 g/d) was administrated for 5 days followed by subsequent dose-tapering prednisone. His limb weakness and aberrant sensation both improved and he was able to walk unaided after treatment. The MRI recheck also showed remarkable improvement on the lesions in spinal cord and vertebral bodies. CONCLUSION this case illustrates the concurrence of possible vasculitis in vertebral bodies and acute transverse myelitis (ATM) following COVID-19 vaccination.
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Affiliation(s)
- Yanyi Chen
- Department of Integrated TCM and Western Medicine, The First Hospital of Changsha, Changsha, Hunan, China
| | - Yuxin Li
- Department of Radiology, The First Hospital of Changsha, Changsha, Hunan, China
| | - Tao Zhan
- Department of Integrated TCM and Western Medicine, The First Hospital of Changsha, Changsha, Hunan, China
- *Correspondence: Tao Zhan, Department of Integrated TCM and Western Medicine, The First Hospital of Changsha, Changsha, Hunan 410005, China (e-mail: )
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Lötscher F, Pop R, Seitz P, Recher M, Seitz L. Spectrum of Large- and Medium-Vessel Vasculitis in Adults: Neoplastic, Infectious, Drug-Induced, Autoinflammatory, and Primary Immunodeficiency Diseases. Curr Rheumatol Rep 2022; 24:293-309. [PMID: 35920952 PMCID: PMC9362566 DOI: 10.1007/s11926-022-01083-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2022] [Indexed: 02/06/2023]
Abstract
Purpose of Review To provide a comprehensive review of drugs and neoplastic, infectious, autoinflammatory, and immunodeficiency diseases causing medium- to large-vessel vasculitis in adults with emphasis on information essential for the initial diagnostic process. Recent Findings Entities with medium- to large-vessel vasculitis as clinical manifestations have been described recently (e.g., adenosine deaminase-2 deficiency, VEXAS-Syndrome), and vasculitis in established autoinflammatory or immunodeficiency diseases is increasingly being identified. Summary In the diagnostic process of medium- to large-vessel vasculitis in adults, a large variety of rare diseases should be included in the differential diagnosis, especially if diagnosis is made without histologic confirmation and in younger patients. Although these disorders should be considered, they will undoubtedly remain rare in daily practice. Supplementary Information The online version contains supplementary material available at 10.1007/s11926-022-01083-5.
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Affiliation(s)
- Fabian Lötscher
- Department of Rheumatology and Immunology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Roxana Pop
- Department of Infectious Diseases and Hospital Hygiene, University Hospital, University of Zurich, Zurich, Switzerland
| | - Pascal Seitz
- Department of Rheumatology and Immunology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland
| | - Mike Recher
- Immunodeficiency Laboratory, Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland.,University Center for Immunology, University Hospital, Basel, Switzerland
| | - Luca Seitz
- Department of Rheumatology and Immunology, Inselspital, University Hospital, University of Bern, Freiburgstrasse, CH-3010, Bern, Switzerland. .,Immunodeficiency Laboratory, Department of Biomedicine, University Hospital and University of Basel, Basel, Switzerland.
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11
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González-Guerra E, Conde Taboada A, Campos Muñoz L, Suárez Solís ML, López-Bran E, Sánchez Fructuoso AI. Vasculitis leucocitoclástica por vacuna de la influenza en un paciente trasplantado renal. Nefrologia 2022. [DOI: 10.1016/j.nefro.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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12
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Vornicu A, Berechet A, Frățilă G, Obrişcă B, Jurcuţ C, Ismail G. Relapse of cryoglobulinemic vasculitis with new-onset severe renal involvement in two patients following mRNA COVID-19 vaccination: A case report. Medicine (Baltimore) 2022; 101:e29431. [PMID: 35687780 PMCID: PMC9276277 DOI: 10.1097/md.0000000000029431] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/20/2022] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Since mass-scale severe acute respiratory syndrome coronavirus 2 vaccination, there have been case reports of several immune-mediated reactions, including new-onset and flares of glomerular disorders following immunization with mRNA coronavirus disease 2019 vaccines. Here, we report two cases, the first to our knowledge, of relapsing cryoglobulinemic vasculitis with new-onset severe renal involvement following mRNA coronavirus disease 2019 vaccination. PATIENT CONCERNS The relapse of the cutaneous and the new onset of severe renal involvement of cryoglobulinemic vasculitis occurred three weeks after the second dose of the mRNA Moderna coronavirus disease 2019 vaccination and two days after the first dose of mRNA Pfizer coronavirus disease 2019 vaccination in the first and second patient, respectively. DIAGNOSIS Kidney biopsies were performed. The first pacient's kidney biopsy showed a membranoproliferative pattern of glomerular injury with extensive mesangial and endocapillary hypercellularity, while severe endothelial swelling, loss of fenestrations and widening of subendothelial space were identified by electron-microscopy. The second patient's kidney biopsy was consistent with cryoglobulin associated membrano-proliferative pattern of glomerular injury. INTERVENTIONS Our patients were managed with a combination of immunosuppressants consisting of corticosteroids, Cyclophosphamide and Rituximab with a favourable outcome at the end of the induction period. OUTCOMES Clinical and immunological response was achieved in both patients after four months of follow-up. LESSONS The temporal association of the relapse of the cryoglobulinemic vasculitis to mRNA coronavirus disease 2019 vaccination suggest that the vaccine might have been a trigger for the reactivation of the disease in our cases. This possible association should be acknowledged by physicians in order to provide optimal monitoring and treatment in case of reactivation of the disease post-immunization.
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Affiliation(s)
- Alexandra Vornicu
- Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Andreea Berechet
- Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania
| | - Georgiana Frățilă
- Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Bogdan Obrişcă
- Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
| | - Ciprian Jurcuţ
- Department of Internal Medicine, “Dr. Carol Davila” Central University Emergency Military Hospital, Bucharest, Romania
| | - Gener Ismail
- Department of Nephrology, Fundeni Clinical Institute, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
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13
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Are finasteride-related penile curvature/Peyronie's disease Adverse Event Reports worthy of further clinical investigation? Disproportionality analysis based on both the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) pharmacovigilance databases. Int J Impot Res 2022:10.1038/s41443-022-00568-2. [PMID: 35513712 DOI: 10.1038/s41443-022-00568-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 01/22/2022] [Accepted: 03/22/2022] [Indexed: 11/09/2022]
Abstract
A limited number of studies have described patients on finasteride showing findings which were consistent with Peyronie's disease (PD). We aimed to detect a pharmacovigilance signal of possible association between finasteride and PD-related clinical features. The Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database was queried to identify the ten drugs which were associated the most with the adverse drug reactions (ADRs) recorded as "penile curvature" and/or "Peyronie's disease". A similar analysis, including the same drugs, was carried out for the EMA (European Medicines Agency) EudraVigilance (EV) database. Descriptive data have been analyzed, and Proportional Reporting Ratios (PRRs) have been computed against the other nine drugs of the database. Overall, 860 reports of "penile curvature" and/or "Peyronie's disease", were identified in the FAERS database, 214 of which (24.9%) were associated with finasteride. Most reports (56.9%) were submitted by healthcare professionals. Where a treatment-indication was stated, the vast majority of reports (176/210; 83.8%) were associated with androgenetic alopecia. The outcome of most ADRs was "serious" (82.2%), with 96 ADRs resulting in levels of permanent disability. For 97/214 individual cases, penile curvature/PD reports were not part of a syndromic cluster suggestive of post-finasteride syndrome (PFS). The PRR resulted 6.6 (95% CI: 5.6-7.8) and 11.8 (95% CI: 9.08-15.33), respectively, in the FAERS and in the EV databases. Notwithstanding the related limitations and biasing factors of pharmacovigilance studies based on spontaneous reporting, the PRR values here identified should be interpreted as strong signals of disproportionality. These findings, per se, are however not useful to confirm any causal association. Clinical studies are needed to investigate on the possible role for finasteride in causing PD-related clinical features, an hypothesis which remains highly speculative due to the very questionable quality of present data.
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14
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Carrillo‐Garcia P, Sánchez‐Osorio L, Gómez‐Pavón J. Leukocytoclastic vasculitis in possible relation to the
BNT162b2 mRNA COVID
‐19 vaccine. J Am Geriatr Soc 2022; 70:971-973. [DOI: 10.1111/jgs.17675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/06/2022] [Accepted: 01/13/2022] [Indexed: 11/30/2022]
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15
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van Laar JA. Can SARS-CoV-2 vaccinations induce auto inflammatory diseases? Rheumatology (Oxford) 2022; 61:SI110-SI111. [PMID: 35020820 PMCID: PMC9383133 DOI: 10.1093/rheumatology/keac008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/13/2021] [Accepted: 12/28/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Jan A van Laar
- Department of Internal Medicine, Division of Allergy & Clinical Immunology, Erasmus University Medical Centre, Rotterdam, the Netherlands.,Laboratory of Medical Immunology, Erasmus University Medical Centre, Rotterdam, The Netherlands
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Abstract
PURPOSE To report a case of acute macular neuroretinopathy after the vaccination for coronavirus disease 2019. METHODS A 22-year-old White woman presented with symptoms of paracentral scotomas within a week of receiving coronavirus disease 2019 vaccination. Complete evaluation was performing using multimodal imaging techniques. RESULTS Spectral domain optical coherence tomography and near-infrared imaging showed characteristic features of acute macular neuroretinopathy. CONCLUSION/DISCUSSION To the best of our knowledge this is the first reported case of acute macular neuroretinopathy after coronavirus disease 2019 vaccination. Optical coherence tomography angiography did not reveal any signal attenuation, and multifocal electroretinogram and central visual fields were normal indicating that near-infrared imaging and spectral domain optical coherence tomography remain the gold standard in diagnosing this condition especially in smaller lesions.
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Affiliation(s)
- Naima Zaheer
- Birmingham and Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
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17
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Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines. J Clin Med 2021; 10:jcm10225344. [PMID: 34830627 PMCID: PMC8618511 DOI: 10.3390/jcm10225344] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 12/19/2022] Open
Abstract
Many patients are receiving SARS-CoV-2 vaccinations, which have been associated with a variety of adverse effects. Cutaneous adverse reactions to SARS-CoV-2 vaccinations have been progressively reported, but they have not been reviewed according to their morphological clinical patterns. The objective of this review was to summarize the existing data concerning the cutaneous adverse reactions following SARS-CoV-2 vaccines and group them according to common morphological and pathogenetic patterns. We reviewed the English language literature up to 15 August 2021, using predefined keywords to identify the relevant studies evaluating cutaneous adverse reactions associated with SARS-CoV-2 vaccines. We search for recurrent morphological patterns sharing clinical signs and symptoms and physio-pathological mechanisms. Timing to onset following the first or booster dose of the vaccine, predisposing conditions, therapeutic management, and outcome were also collected. Among the dermatological manifestations associated with SARS-CoV-2 vaccinations, we distinguished: (1) new onset reactions and (2) flares of preexisting dermatoses. The most common were injection site reactions, affecting 30–70% and generally mild or moderate. Small case series or single case reports included filler reactions, exanthemas, vascular lesions, urticaria, eczematous dermatitis, autoimmune bullous reactions, and severe cutaneous adverse reactions. In addition, the exacerbation of chronic immuno-mediated dermatoses (mainly psoriasis and atopic dermatitis) and reactivations of herpes infection were reported. The cutaneous reactions were generally mild, self-limiting, and resembled common cutaneous drug eruptions and/or COVID-19 skin manifestations.
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18
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Cutaneous Lymphocytic Vasculitis After Administration of the Second Dose of AZD1222 (Oxford-AstraZeneca) Severe Acute Respiratory Syndrome Coronavirus 2 Vaccination: Casuality or Causality? Am J Dermatopathol 2021; 44:80-82. [PMID: 34726187 DOI: 10.1097/dad.0000000000002104] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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19
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Colia R, Rotondo C, Corrado A, Cantatore FP. Cutaneous vasculitis after severe acute respiratory syndrome coronavirus 2 vaccine. Rheumatol Adv Pract 2021; 5:rkab050. [PMID: 34557622 PMCID: PMC8452996 DOI: 10.1093/rap/rkab050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/21/2021] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ripalta Colia
- Rheumatology Clinic, Department of Medical and Surgical Science, University of Foggia Policlinico Riuniti, Foggia, Italy
| | - Cinzia Rotondo
- Rheumatology Clinic, Department of Medical and Surgical Science, University of Foggia Policlinico Riuniti, Foggia, Italy
| | - Addolorata Corrado
- Rheumatology Clinic, Department of Medical and Surgical Science, University of Foggia Policlinico Riuniti, Foggia, Italy
| | - Francesco P Cantatore
- Rheumatology Clinic, Department of Medical and Surgical Science, University of Foggia Policlinico Riuniti, Foggia, Italy
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20
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Sirufo MM, Raggiunti M, Magnanimi LM, Ginaldi L, De Martinis M. Henoch-Schönlein Purpura Following the First Dose of COVID-19 Viral Vector Vaccine: A Case Report. Vaccines (Basel) 2021; 9:vaccines9101078. [PMID: 34696186 PMCID: PMC8539285 DOI: 10.3390/vaccines9101078] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/13/2021] [Accepted: 09/22/2021] [Indexed: 01/03/2023] Open
Abstract
A 76 year-old female came to our observation one week after the vaccination with ChAdOx1 nCoV-19 AZD1222 for the onset of purpuric rash on her gluteal and legs regions associated with coxalgia and episodes of macrohaematuria. Henoch-Schönlein purpura (HSP) was diagnosed on the basis of the revised criteria developed by the European League Against Rheumatism, the Paediatric Rheumatology International Trials Organization, and the Paediatric Rheumatology European Society (EULAR/PRINTO/PRES). HSP is a common IgA-mediated small vessel vasculitis, typical of childhood, that affects several systems and is characterized by a tetrad of dermatological, abdominal, joint, and renal manifestations. The Etiology of HSP is not completely understood, but it was observed following upper respiratory tract infections, medications, vaccinations, and malignancies. HSP has previously been reported following immunization with various vaccines, mostly within 12 weeks post, suggesting a possible correlation. To our knowledge, this is the first report of the possible association between COVID-19 ChAdOx1 nCoV-19 AZD1222 and the onset of HSP in a previously healthy woman. No similar cases were reported amongst 23.848 participants in the ChAdOx1 nCoV-19 AZD1222 trial.
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Affiliation(s)
- Maria Maddalena Sirufo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (M.R.); (L.M.M.); (L.G.)
- Allergy and Clinical Immunology Unit, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Martina Raggiunti
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (M.R.); (L.M.M.); (L.G.)
- Allergy and Clinical Immunology Unit, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Lina Maria Magnanimi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (M.R.); (L.M.M.); (L.G.)
| | - Lia Ginaldi
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (M.R.); (L.M.M.); (L.G.)
- Allergy and Clinical Immunology Unit, AUSL 04 Teramo, 64100 Teramo, Italy
| | - Massimo De Martinis
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.M.S.); (M.R.); (L.M.M.); (L.G.)
- Allergy and Clinical Immunology Unit, AUSL 04 Teramo, 64100 Teramo, Italy
- Correspondence:
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21
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Iwata H, Kamiya K, Kado S, Nakaya T, Kawata H, Komine M, Ohtsuki M. Case of immunoglobulin A vasculitis following coronavirus disease 2019 vaccination. J Dermatol 2021; 48:e598-e599. [PMID: 34535924 PMCID: PMC8652428 DOI: 10.1111/1346-8138.16167] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/05/2021] [Accepted: 09/07/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Hiroka Iwata
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Koji Kamiya
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Soichiro Kado
- Department of Dermatology, Ibaraki Western Medical Center, Chikusei, Japan
| | - Takeo Nakaya
- Department of Pathology, Jichi Medical University, Shimotsuke, Japan
| | - Hirotoshi Kawata
- Department of Pathology, Jichi Medical University, Shimotsuke, Japan
| | - Mayumi Komine
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
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Banday AZ, Arul A, Vignesh P, Singh MP, Goyal K, Singh S. Kawasaki disease and influenza-new lessons from old associations. Clin Rheumatol 2021; 40:2991-2999. [PMID: 33387094 PMCID: PMC7778392 DOI: 10.1007/s10067-020-05534-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/21/2022]
Abstract
Kawasaki disease (KD), an enigmatic medium vessel vasculitis, presents as an acute febrile illness predominantly affecting young children. KD appears to be a hyper-inflammatory response elicited by environmental or infectious agents (including respiratory viruses) in genetically predisposed individuals. Numerous reports from the current era of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic have described the occurrence of KD/KD-like illness in close temporal proximity to SARS-CoV-2 infection or exposure. Notably, KD has been reported in association with H1N1-pdm09 virus that caused the previous pandemic a decade ago. Non-H1N1 influenza infections as well as influenza vaccination have also been reported to trigger KD. Herein, we report a case of H1N1-pdm09 influenza who developed KD. We review the published literature on influenza infection or vaccination triggering KD. This may help in a better understanding of the KD/KD-like illness associated with SARS-CoV-2. Besides, we also evaluate the safety of aspirin in influenza-triggered KD as aspirin administration in children with influenza is associated with the risk of development of Reye syndrome.
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Affiliation(s)
- Aaqib Zaffar Banday
- Allergy Immunology Unit, Advanced Pediatrics Centre (APC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Ashwini Arul
- Allergy Immunology Unit, Advanced Pediatrics Centre (APC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Pandiarajan Vignesh
- Allergy Immunology Unit, Advanced Pediatrics Centre (APC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | | | - Kapil Goyal
- Department of Virology, PGIMER, Chandigarh, India
| | - Surjit Singh
- Allergy Immunology Unit, Advanced Pediatrics Centre (APC), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
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Hines AM, Murphy N, Mullin C, Barillas J, Barrientos JC. Henoch-Schönlein purpura presenting post COVID-19 vaccination. Vaccine 2021; 39:4571-4572. [PMID: 34247902 PMCID: PMC8241653 DOI: 10.1016/j.vaccine.2021.06.079] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/11/2021] [Accepted: 06/25/2021] [Indexed: 11/12/2022]
Affiliation(s)
- Adam M Hines
- Northwell Health Cancer Institute, New York, United States
| | - Neal Murphy
- Northwell Health Cancer Institute, New York, United States
| | - Christine Mullin
- North Shore University Division of Maternal Fetal Medicine, Northwell Health, New York, United States
| | - Julia Barillas
- Woodhull NYC Health + Hospitals, New York, United States
| | - Jacqueline C Barrientos
- Northwell Health Cancer Institute, New York, United States; Zucker School of Medicine at Hofstra/Northwell, New York, United States.
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Awad MH, El-Hawary A, Sawah G, Nasef N. Pan-vasculitis and fulminant hepatitis following routine vaccination at the age of 4 months. Clin Exp Vaccine Res 2021; 10:78-80. [PMID: 33628757 PMCID: PMC7892943 DOI: 10.7774/cevr.2021.10.1.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 11/17/2022] Open
Abstract
Vaccines are known to have side effects, most of which are tolerable. Vasculitis following vaccination is reported and has various modes of presentation. We report a 4-month-old girl presented with an unusual presentation of fulminant hepatitis, pan vasculitis, and diffuse body aneurysms following routine immunization diagnosed by echocardiography and computed tomography angiogram. It is important to be aware of different possible adverse effects following vaccines and their different modes of presentation as well as possible treatments such as intravenous immunoglobulins and high dose methylprednisolone.
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Affiliation(s)
- Mohammad Hosny Awad
- Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt
| | - Amany El-Hawary
- Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt
| | - Gehan Sawah
- Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt
| | - Nehad Nasef
- Department of Pediatrics, Faculty of Medicine, University of Mansoura, Mansoura, Egypt
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Liozon E, Parreau S, Filloux M, Dumonteil S, Gondran G, Bezanahary H, Ly KH, Fauchais AL. Giant cell arteritis or polymyalgia rheumatica after influenza vaccination: A study of 12 patients and a literature review. Autoimmun Rev 2020; 20:102732. [PMID: 33326851 DOI: 10.1016/j.autrev.2020.102732] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 10/24/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are inflammatory rheumatic diseases common in people over the age of 50 years. Seasonal influenza vaccination (IV) is strongly recommended in this population, among whom it is considered to be effective and well tolerated. IV-induced GCA or PMR are thought to be exceptional. PATIENTS AND METHODS We retrieved all post-IV cases from an inception cohort of patients with newly diagnosed GCA. We also included two patients with post-IV PMR and reviewed all published reports of post-IV GCA or PMR, with selection of cases demonstrating disease onset within 1 month following IV. We compared the results of HLA-DRB1 typing, performed in seven patients with post-IV GCA or PMR, with those of 11 GCA patients with familial aggregation and 16 randomly selected GCA patients without a reported trigger. RESULTS Of 358 GCA recruited since 2002, 10 (2.8%) qualified for post-IV GCA, of whom two also showed familial aggregation. Thirty-two patients (19 with GCA and 13 with PMR) including our patients were reviewed; their mean age was 71.8 ± 7.4 years and the M/F ratio was 0.8. Six patients (19%) had a history of PMR. Patients with post-IV GCA/PMR had the DRB1*13:01 haplotype more frequently compared to those with familial GCA (5/7 vs. 2/11, p = 0.048) or with GCA without a known trigger (3/16, p = 0.026). Post-IV PMR generally appeared self-limited, whereas post-IV GCA often displayed a more protracted course (chronic relapsing disease in one-third of the patients). CONCLUSION Post-IV onset of GCA/PMR is not an exceptional occurrence and may be part of the spectrum of the autoimmune syndrome induced by adjuvants (ASIA). IV can trigger GCA or PMR, especially in persons at higher spontaneous risk, such as those with a personal or familial history of GCA/PMR. Whether the presence of the DRB1*13:01 allele further increases the risk of post-IV GCA/PMR through a stronger vaccine-induced immune reaction deserves further investigation. Unlike PMR, GCA can be a serious complication of IV.
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Affiliation(s)
- Eric Liozon
- Departments of Internal Medicine, University Hospital of Limoges, Limoges Cedex, France.
| | - Simon Parreau
- Departments of Internal Medicine, University Hospital of Limoges, Limoges Cedex, France
| | - Matthieu Filloux
- Immunology and Immunogenetics, University Hospital of Limoges, Limoges Cedex, France
| | - Stéphanie Dumonteil
- Departments of Internal Medicine, University Hospital of Limoges, Limoges Cedex, France
| | - Guillaume Gondran
- Departments of Internal Medicine, University Hospital of Limoges, Limoges Cedex, France
| | - Holy Bezanahary
- Departments of Internal Medicine, University Hospital of Limoges, Limoges Cedex, France
| | - K H Ly
- Departments of Internal Medicine, University Hospital of Limoges, Limoges Cedex, France
| | - Anne Laure Fauchais
- Departments of Internal Medicine, University Hospital of Limoges, Limoges Cedex, France
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Schifano F. Coming Off Prescribed Psychotropic Medications: Insights from Their Use as Recreational Drugs. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 89:274-282. [PMID: 32615566 DOI: 10.1159/000507897] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom,
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Seo YB, Moon SJ, Jeon CH, Song JY, Sung YK, Jeong SJ, Kwon KT, Kim ES, Kim JH, Kim HA, Park DJ, Park SH, Park JK, Ahn JK, Oh JS, Yun JW, Lee JH, Lee HY, Choi MJ, Choi WS, Choi YH, Choi JH, Heo JY, Cheong HJ, Lee SS. The Practice Guideline for Vaccinating Korean Patients With Autoimmune Inflammatory Rheumatic Disease. JOURNAL OF RHEUMATIC DISEASES 2020. [DOI: 10.4078/jrd.2020.27.3.182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Korea
| | - Su-Jin Moon
- Division of Rheumatology, Department of Internal Medicine, Uijeongbu St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Chan Hong Jeon
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoon-Kyoung Sung
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Su Jin Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Eu Suk Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Hoon Kim
- Department of Rheumatology, Korea University Guro Hospital, Seoul, Korea
| | - Hyoun-Ah Kim
- Department of Rheumatology, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Dong-Jin Park
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Korea
| | - Sung-Hoon Park
- Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Jin Kyun Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Joong Kyong Ahn
- Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Seon Oh
- Department of Information Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Won Yun
- Division of Infectious Disease Control, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Joo-Hyun Lee
- Division of Rheumatology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Hee Young Lee
- Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Joo Choi
- Division of Infectious Disease, Department of Internal Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Young Hwa Choi
- Department of Infectious Diseases, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Jung-Hyun Choi
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea, Eunpyeong St. Mary’s Hospital, Seoul, Korea
| | - Jung Yeon Heo
- Department of Infectious Diseases, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Shin-Seok Lee
- Department of Rheumatology, Chonnam National University Medical School and Hospital, Gwangju, Korea
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Abdalla A, Sebaoui S, Alraqi S. Diffuse cutaneous reaction following PPV-23 pneumococcal vaccine: an immunisation-associated hypersensitivity vasculitis. BMJ Case Rep 2020; 13:13/3/e234714. [DOI: 10.1136/bcr-2020-234714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Seo YB, Moon SJ, Jeon CH, Song JY, Sung YK, Jeong SJ, Kwon KT, Kim ES, Kim JH, Kim HA, Park DJ, Park SH, Park JK, Ahn JK, Oh JS, Yun JW, Lee JH, Lee HY, Choi MJ, Choi WS, Choi YH, Choi JH, Heo JY, Cheong HJ, Lee SS. The Practice Guideline for Vaccinating Korean Patients with Autoimmune Inflammatory Rheumatic Disease. Infect Chemother 2020; 52:252-280. [PMID: 32618150 PMCID: PMC7335656 DOI: 10.3947/ic.2020.52.2.252] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/11/2020] [Indexed: 01/03/2023] Open
Abstract
To develop a clinical practice guideline for vaccination in patients with autoimmune inflammatory rheumatic disease (AIIRD), the Korean College of Rheumatology and the Korean Society of Infectious Diseases developed a clinical practice guideline according to the clinical practice guideline development manual. Since vaccination is unlikely to cause AIIRD or worsen disease activities, required vaccinations are recommended. Once patients are diagnosed with AIIRD, treatment strategies should be established and, at the same time, monitor their vaccination history. It is recommended to administer vaccines when the disease enters the stabilized stage. Administering live attenuated vaccines in patients with AIIRD who are taking immunosuppressants should be avoided. Vaccination should be considered in patients with AIIRD, prior to initiating immunosuppressants. It is recommended to administer influenza, Streptococcus pneumoniae, hepatitis A, hepatitis B, herpes zoster, measles-mumps-rubella virus, human papillomavirus, and tetanus-diphtheria-pertussis vaccines in patients with AIIRD; such patients who planned to travel are generally recommended to be vaccinated at the recommended vaccine level of healthy adults. Those who live in a household with patients with AIIRD and their caregivers should also be vaccinated at levels that are generally recommended for healthy adults.
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Affiliation(s)
- Yu Bin Seo
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Su Jin Moon
- Division of Rheumatology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea
| | - Chan Hong Jeon
- Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Guro Hospital, Seoul, Korea
| | - Yoon Kyoung Sung
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
| | - Su Jin Jeong
- Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - Eu Suk Kim
- Division of Infectious Diseases, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae Hoon Kim
- Department of Rheumatology, Korea University Guro Hospital, Seoul, Korea
| | - Hyoun Ah Kim
- Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
| | - Dong Jin Park
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Korea
| | - Sung Hoon Park
- Division of Rheumatology, Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea
| | - Jin Kyun Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Joong Kyong Ahn
- Division of Rheumatology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Seon Oh
- Department of Information Medicine, Asan Medical Center, Seoul, Korea
| | - Jae Won Yun
- Division of Infectious Disease Control, Korea Centers for Disease Control and Prevention, Osong, Korea
| | - Joo Hyun Lee
- Division of Rheumatology, Department of Internal Medicine, College of Medicine, Inje University Ilsan Paik Hospital, Ilsan, Korea
| | - Hee Young Lee
- Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Joo Choi
- Division of Infectious Disease, Department of Internal Medicine, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Korea
| | - Won Suk Choi
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Ansan Hospital, Ansan, Korea
| | - Young Hwa Choi
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Korea
| | - Jung Hyun Choi
- Division of Infectious Diseases, Department of Internal Medicine, The Catholic University of Korea, Eunpyeong St. Mary's Hospital, Seoul, Korea
| | - Jung Yeon Heo
- Department of Infectious Diseases, Ajou University School of Medicine, Suwon, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Guro Hospital, Seoul, Korea.
| | - Shin Seok Lee
- Department of Rheumatology, Chonnam National University Medical School & Hospital, Gwangju, Korea.
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Bassendine MF, Bridge SH. Relapse of polymyalgia rheumatica following adjuvanted influenza vaccine: A case-based review. Eur J Rheumatol 2019; 7:37-40. [PMID: 31922479 DOI: 10.5152/eurjrheum.2019.19152] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 09/09/2019] [Indexed: 01/18/2023] Open
Abstract
Polymyalgia rheumatica (PMR) is the most common inflammatory rheumatological condition affecting individuals aged >50 years. There have been rare reports of PMR and other vasculitides developing within 3 months of influenza vaccination. Influenza is a major public health issue associated with seasonal increased mortality and intensified health care service use. Annual vaccination is the most effective intervention to prevent influenza, especially in elderly individuals. We report a severe "flare" of PMR in a 70-year-old patient after receiving the adjuvanted trivalent influenza vaccine, as recommended by the Joint Committee on Vaccination and Immunisations for this age group in the UK National Health Service in 2018-2019. The adverse event (AE) could be interpreted as the newly described autoimmune/inflammatory syndrome induced by adjuvants (ASIA syndrome) as both PMR and ASIA display hyperactive immune responses. Caution is warranted in the use of vaccine adjuvants in patients with PMR with pre-existing imbalance of B and T cell homeostasis. Rare AEs are important to individuals, and personalized medicine means we should move away from "one size fits all" for vaccines, as well as for therapeutics.
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Affiliation(s)
- Margaret F Bassendine
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,Department of Hepatology & Gastroenterology, Imperial College London, London, UK
| | - Simon H Bridge
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.,Northumbria University, School of Health and Life Sciences, Newcastle upon Tyne, UK
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31
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Eid S, Callen JP. Type II mixed cryoglobulinemia following influenza and pneumococcal vaccine administration. JAAD Case Rep 2019; 5:960-962. [PMID: 31687464 PMCID: PMC6820236 DOI: 10.1016/j.jdcr.2019.08.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
| | - Jeffrey P. Callen
- Correspondence to: Jeffrey P. Callen, MD, Chief of the Division of Dermatology, Professor of Medicine, 3810 Springhurst Blvd. #200, Louisville KY 40241.
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32
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Wang J, Sun F, Deng HL, Liu RQ. Influenza A (H1N1) pdm09 virus infection in a patient with incomplete Kawasaki disease: A case report. Medicine (Baltimore) 2019; 98:e15009. [PMID: 30985646 PMCID: PMC6485757 DOI: 10.1097/md.0000000000015009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Kawasaki disease (KD) is a vasculitic illness of childhood associated with coronary artery dilatation, coronary artery aneurysm, arrhythmia, sudden death, and other serious cardiovascular diseases. Up to date, the etiology of KD remains unclear; however, epidemiological characteristics indicate that it may be related to as-yet-undefined pathogen infection. PATIENT CONCERNS A 19-month-old boy had a fever of unknown origin at 38°C for 9 days without rash, runny nose and cough. DIAGNOSIS The boy was diagnosed with incomplete KD (IKD) coincident with influenza A (H1N1) pdm09 virus. INTERVENTIONS He was received treatments including human immunoglobulin (2 g/kg), aspirin (30∼50 mg/kg.d), and dipyridamole (3∼5 mg/kg.d). OUTCOMES After 24 hours of human immunoglobulin infusion, his body temperature returned normal. After hospitalization for 6 days, his symptoms disappeared and discharged from the hospital. LESSONS More attention should be paid to the correlation between KD and pathogen infection, especially the new influenza virus H1N1. The potential mechanism underlying viral infection-mediated KD is worthy of further investigation, which may provide scientific evidence for the pathogenesis of KD.
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Affiliation(s)
- Jun Wang
- Department Second of Infectious Diseases
| | - Fang Sun
- Department of Respiratory, Xi’an Children's Hospital, Xi’an, Shaanxi Province, China
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Fernández Prada M, Alonso Penanes P, Morales Del Burgo P, Pérez Martinez I, Villa Del Amo MC. Leukocytoclastic vasculitis after vaccination in a patient with inflammatory bowel disease. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2019; 111:402-404. [PMID: 30859841 DOI: 10.17235/reed.2019.5963/2018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Patients with inflammatory bowel disease are likely to receive immunomodulation treatment and therefore, should be properly vaccinated. Despite their proven safety, vaccines are not exempt from adverse reactions. The clinical case was a young female with ulcerative colitis under mesalazine treatment, who developed leukocytoclastic vasculitis following vaccination for pneumococci, varicella and hepatitis A. This adverse reaction after the previously mentioned vaccines is barely described in the literature and has never been reported in a patient with an underlying condition.
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Affiliation(s)
- María Fernández Prada
- Servicio de Medicina Preventiva y Salud Pública, Hospital Vital Álvarez Buylla, Mieres. Asturias., España
| | | | | | - Isabel Pérez Martinez
- Unidad Enf. Inflam. Intest. Servicio de Digestivo., Hospital Universitario Central de Asturias
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A 19-year old man with IgA vasculitis after vaccination. Braz J Infect Dis 2018; 22:442-444. [PMID: 30389353 PMCID: PMC9428013 DOI: 10.1016/j.bjid.2018.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/18/2018] [Accepted: 09/20/2018] [Indexed: 11/27/2022] Open
Abstract
A 19-year-old patient who mistakenly received two doses of influenza vaccine 10 days before presentation, was admitted with malaise, weakness, and a purpuric non-blanching rash most prominent on the ankles followed by abdominal pain and hematochezia 72 h later. The diagnosis of influenza vaccine-related Henoch–Schonlein vasculitis was made. This complication, although rare, is the most common vasculitis related to immunization.
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Velasco-Tamariz V, Prieto-Barrios M, Tous-Romero F, Palencia-Pérez SI, Postigo-Llorente C. Urticarial vasculitis after meningococcal serogroup B vaccine in a 6-year-old girl. Pediatr Dermatol 2018; 35:e64-e65. [PMID: 29164681 DOI: 10.1111/pde.13339] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The first vaccine that shows significant potential in providing broad coverage against serogroup B meningococcal disease has recently been approved. Because of its newness, potential adverse events need to be reported. Here we report a case of urticarial vasculitis, a rare disease in children, in probable relationship with the novel vaccine.
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Eindhoven S, Levels J, Huisman M, de Winter KR, Dalm V, Alwani R. MPO-ANCA associated vasculitis with mononeuritis multiplex following influenza vaccination. Allergy Asthma Clin Immunol 2017; 13:49. [PMID: 29255476 PMCID: PMC5727957 DOI: 10.1186/s13223-017-0222-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 11/06/2017] [Indexed: 11/14/2022] Open
Abstract
Background Although influenza vaccines are generally safe and effective, a variety of autoimmune phenomena have been reported after vaccination over the past years, such as Guillain–Barre syndrome, rheumatoid arthritis, pemphigus vulgaris, psoriasis, giant cell arteritis and anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Case report We describe the case of a 67-year old man who presented with a myeloperoxidase-ANCA associated vasculitis with renal involvement and mononeuritis multiplex after seasonal influenza vaccination. He was initially treated with intravenous cyclophosphamide and high-dose prednisolone followed by maintenance treatment consisting of azathioprine and prednisolone. Conclusion We hypothesize that seasonal influenza vaccination triggered a systemic immune response in a susceptible patient to develop AAV with renal involvement and vasculitic neuropathy. In general, seasonal influenza vaccinations are considered to be safe, however, clinicians should be aware of this rare phenomenon.
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Affiliation(s)
- Stefanie Eindhoven
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands.,Department of Internal Medicine, Room F104, IJsselland Hospital, P.O. Box 690, 2900 AR Capelle aan den IJssel, The Netherlands
| | - Jolien Levels
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands
| | - Margriet Huisman
- Division of Rheumatology, Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands
| | | | - Virgil Dalm
- Division of Clinical Immunology, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands.,Department of Immunology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Rehmat Alwani
- Department of Internal Medicine, IJsselland Hospital, Capelle aan den IJssel, The Netherlands
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Rákóczi É, Szekanecz Z. Pneumococcal vaccination in autoimmune rheumatic diseases. RMD Open 2017; 3:e000484. [PMID: 28955497 PMCID: PMC5604716 DOI: 10.1136/rmdopen-2017-000484] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/11/2017] [Accepted: 08/14/2017] [Indexed: 12/19/2022] Open
Abstract
Streptococcus pneumoniae is the leading cause of the community-acquired pneumonia. The mortality rate of invasive pneumococcal infections is high. Immunocompromised patients suffering from autoimmune inflammatory rheumatic diseases (AIRD) have a high risk for acquiring these infections. Protection against infection can be improved with vaccination. After using polysaccharide vaccines (PPV-23), in July 2013, a 13-valent conjugate vaccine (PCV-13) was approved for adults. Due to its conjugate form, this vaccine is the recommended choice in pneumococcal vaccine-naive patients. PCV-13 is also recommended in patients previously receiving PPV-23. Vaccination in AIRD is very important and needs deliberate scheduling to coordinate with the immunosuppressive therapy. Here, based on international and national vaccine guidelines, we provide a current review of PPV-23 and PCV-13 vaccines for specialists following patients with AIRD.
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Affiliation(s)
- Éva Rákóczi
- Institute of Infectious Diseases, University of Debrecen Faculty of Medicine, Kenézy University Hospital, Debrecen, Hungary.,Division of Rheumatology, Department of Medicine, University of Debrecen Faculty of Medicine, Debrecen, Hungary
| | - Zoltan Szekanecz
- Division of Rheumatology, Department of Medicine, University of Debrecen Faculty of Medicine, Debrecen, Hungary
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Tang C, Scaramangas-Plumley D, Nast CC, Mosenifar Z, Edelstein MA, Weisman M. A Case of Henoch-Schonlein Purpura Associated with Rotavirus Infection in an Elderly Asian Male and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2017; 18:136-142. [PMID: 28174414 PMCID: PMC5310226 DOI: 10.12659/ajcr.901978] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Patient: Male, 73 Final Diagnosis: Henoch-Schönlein purpura (HSP) Symptoms: Abdominal pain • bloating • blood in stool • nausea • vomiting Medication: — Clinical Procedure: EGD • colonoscopy • kidney biopsy • skin biopsy • arthrocentesis Specialty: Rheumatology
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Affiliation(s)
- Chen Tang
- Department of Internal Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | - Cynthia C Nast
- Department of Pathology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Zab Mosenifar
- Department of Nephrology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Marc A Edelstein
- Department of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Michael Weisman
- Department of Rheumatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Chiappini S, Schifano F. A Decade of Gabapentinoid Misuse: An Analysis of the European Medicines Agency's 'Suspected Adverse Drug Reactions' Database. CNS Drugs 2016; 30:647-54. [PMID: 27312320 DOI: 10.1007/s40263-016-0359-y] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
INTRODUCTION The gabapentinoids pregabalin and gabapentin are being increasingly prescribed for a range of clinical conditions. Recently, although gabapentinoids at therapeutic dosages may present with low addictive liability levels, cases of misuse and rising numbers of related fatalities have been reported. OBJECTIVES The aim of the study was to identify and assess cases of gabapentinoid misuse or dependence as reported to the European Medicines Agency's EudraVigilance database, to identify the magnitude of this problem and the characteristics of these reactions. METHODS All spontaneous reports of both gabapentin- (2004-2015) and pregabalin- (2006-2015) related misuse/abuse/dependence were retrieved. A descriptive analysis by source, sex, age, and type of report was performed. RESULTS From the EudraVigilance database 7639 (6.6 % of a total of 115,616) and 4301 (4.8 % of 90,166) adverse drug reaction reports of misuse/abuse/dependence were, respectively, associated with pregabalin and gabapentin, with an overall reporting frequency increasing over time. For both molecules, subjects typically involved were female adults. A total of 27 and 86 fatalities, respectively, associated with pregabalin and gabapentin, and mostly in combination with opioids, were identified. Analysis of proportional reporting ratios for drug abuse/dependence/intentional product misuse values seem to indicate that these adverse drug reactions were more frequently reported for pregabalin (1.25, 1.39, and 1.58, respectively) compared with gabapentin. CONCLUSIONS Despite data collection/methodological approach limitations, the present data seem to suggest that gabapentinoid misuse may be a cause for concern, especially in patients with a history of substance misuse. Hence, healthcare professionals should be vigilant when prescribing these molecules.
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Affiliation(s)
- Stefania Chiappini
- Department of Psychiatry, Catholic University School of Medicine, Largo Agostino Gemelli 8, Rome, 00168, Italy.
| | - Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK
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