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Zhu J, Cheng W, Xu Y, Guo Y, Shi L. Two cases of small bowel necrosis due to intussusception secondary to abnormal proliferation of intestinal Peyer's patches in infants after MMR vaccination. BMC Pediatr 2024; 24:147. [PMID: 38418948 PMCID: PMC10903061 DOI: 10.1186/s12887-024-04618-0] [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: 11/07/2023] [Accepted: 02/03/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Intussusception is one of the most common acute abdominal conditions in pediatric patients, and if left untreated, it may result in intestinal necrosis and even death. The etiology of the disease is unknown and may be related to a variety of factors, and there are only limited reports of small bowel necrosis secondary to abnormal Peyer's node hyperplasia after MMR vaccination. CASE PRESENTATION In this report, we present two infants who had an abnormal proliferation of Peyer's nodes secondary to intussusception eventually leading to small bowel necrosis after MMR vaccination. CONCLUSIONS Intestinal necrosis and infectious shock are the most common causes of infant mortality, and early detection and management are critical.
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Affiliation(s)
- Junzhao Zhu
- Xi'an International Medical Center Hospital Affiliated to Northwest University, No.777 Xitai Road, Chang'an District, Xi'an City, Shaanxi Province, China
| | - Weiping Cheng
- The Affiliated Hospital of Northwest University/Xi'an No.3 Hospital, No. 10 East Section of Fengcheng 3rd Road, Weiyang District, Xi'an , China
| | - Youbo Xu
- Xi'an International Medical Center Hospital Affiliated to Northwest University, No.777 Xitai Road, Chang'an District, Xi'an City, Shaanxi Province, China
| | - Yingqiang Guo
- Xi'an International Medical Center Hospital Affiliated to Northwest University, No.777 Xitai Road, Chang'an District, Xi'an City, Shaanxi Province, China
| | - Lexiang Shi
- Xi'an International Medical Center Hospital Affiliated to Northwest University, No.777 Xitai Road, Chang'an District, Xi'an City, Shaanxi Province, China.
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Ohkubo Y, Ohmura SI, Ishihara R, Miyamoto T. Possible case of polyarteritis nodosa with epididymitis following COVID-19 vaccination: A case report and review of the literature. Mod Rheumatol Case Rep 2022; 7:172-176. [PMID: 36305628 PMCID: PMC9620383 DOI: 10.1093/mrcr/rxac085] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/21/2022] [Accepted: 10/21/2022] [Indexed: 11/07/2022]
Abstract
The global outbreak of coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus type 2 has prompted the rapid spread and development of vaccines to prevent the spread of the disease. COVID-19 vaccine has demonstrated excellent efficacy in reducing morbidity and severity of the disease, and most adverse reactions are very minor. However, some patients have been reported to develop autoimmune diseases, such as rheumatoid arthritis, myocarditis, Guillain-Barre syndrome, and vasculitis, following COVID-19 vaccination. Herein, we present a case of polyarteritis nodosa with epididymitis, following COVID-19 mRNA vaccination. The patient's initial symptoms were fever and testicular pain, and magnetic resonance imaging showed epididymitis. He was diagnosed as having polyarteritis nodosa with epididymitis and was treated with high-dose prednisolone, with a good clinical outcome.
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Affiliation(s)
- Yusuke Ohkubo
- Department of Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu Shizuoka, Japan
| | - Shin-ichiro Ohmura
- correspondence to: Shin-ichiro Ohmura, Division of Rheumatology, Seirei Hamamatsu General Hospital,2-12-12 Sumiyoshi, Naka-ku, Hamamatsu-city, Shizuoka 430–8558, Japan E-mail:
| | - Ryuhei Ishihara
- Department of Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu Shizuoka, Japan
| | - Toshiaki Miyamoto
- Department of Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu Shizuoka, Japan
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Mungmunpuntipantip R, Wiwanitkit V. COVID-19 vaccination, orchitis and epididymitis. Andrologia 2021; 54:e14340. [PMID: 34866218 DOI: 10.1111/and.14340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/04/2021] [Accepted: 11/17/2021] [Indexed: 11/28/2022] Open
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Wu H, Wang F, Tang D, Han D. Mumps Orchitis: Clinical Aspects and Mechanisms. Front Immunol 2021; 12:582946. [PMID: 33815357 PMCID: PMC8013702 DOI: 10.3389/fimmu.2021.582946] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/04/2021] [Indexed: 12/12/2022] Open
Abstract
The causative agent of mumps is a single-stranded, non-segmented, negative sense RNA virus belonging to the Paramyxoviridae family. Besides the classic symptom of painfully swollen parotid salivary glands (parotitis) in mumps virus (MuV)-infected men, orchitis is the most common form of extra-salivary gland inflammation. Mumps orchitis frequently occurs in young adult men, and leads to pain and swelling of the testis. The administration of MuV vaccines in children has been proven highly effective in reducing the incidence of mumps. However, a recent global outbreak of mumps and the high rate of orchitis have recently been considered as threats to male fertility. The pathogenesis of mumps orchitis remains largely unclear due to lack of systematic clinical data analysis and animal models studies. The alarming increase in the incidence of mumps orchitis and the high risk of the male fertility have thus become a major health concern. Recent studies have revealed the mechanisms by which MuV-host cells interact and MuV infection induces inflammatory responses in testicular cells. In this mini-review, we highlight advances in our knowledge of the clinical aspects and possible mechanisms of mumps orchitis.
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Affiliation(s)
- Han Wu
- Department of Immunology, Shenzhen University School of Medicine, Shenzhen, China.,Institute of Basic Medical Sciences, School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Fei Wang
- Institute of Basic Medical Sciences, School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Dongdong Tang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Daishu Han
- Institute of Basic Medical Sciences, School of Basic Medicine, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Ternavasio-de la Vega HG, Boronat M, Ojeda A, García-Delgado Y, Ángel-Moreno A, Carranza-Rodríguez C, Bellini R, Francès A, Nóvoa FJ, Pérez-Arellano JL. Mumps orchitis in the post-vaccine era (1967-2009): a single-center series of 67 patients and review of clinical outcome and trends. Medicine (Baltimore) 2010; 89:96-116. [PMID: 20517181 DOI: 10.1097/md.0b013e3181d63191] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Since the introduction of the mumps vaccine, the age of appearance of mumps infection has shifted from children to adolescents and young adults, groups with a higher incidence of disease complications and sequelae. During the years 2000-2001, the Gran Canaria Island was part of an epidemic of mumps. In that period, our institution attended 67 cases of serologically confirmed acute mumps orchitis, the most serious complication of mumps infection in young postpubertal males. We conducted a descriptive and prospective study of this cohort and extensively reviewed the literature from 1967 (the year the first mumps vaccine was introduced) to 2009. Fifty-six patients were admitted because of general impairment and were treated with alpha-interferon. Sixty-six patients presented parotitis previous to orchitis (interval from parotitis to orchitis, 4.9 d). Orchitis was unilateral in 89.5% and bilateral in 10.4% of cases. More than 98% of patients had orchitis-associated fever. Nine patients had clinical and biochemical data showing acute mumps meningitis, and 11 had subclinical pancreatitis. The mean duration of symptoms was 4.6 days (range, 1-9). During the acute phase, more than 41% of the evaluated testes had a volume >25 mL. Acute hormonal disturbances were highly prevalent. These included decreased levels of testosterone and inhibin B with low or normal levels of gonadotropins in 35% of subjects, and, to our knowledge not previously reported, an atypical hormonal pattern consisting of low levels of free testosterone and inhibin B, along with increased measures of luteinizing hormone but low or normal follicle-stimulating hormone levels (11% of cases). During the follow-up period (mean, 331 d) a high incidence of sperm disturbance was found.
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Affiliation(s)
- Hugo-Guillermo Ternavasio-de la Vega
- From Internal Medicine Service II (HGTV), Hospital Universitario of Salamanca, Salamanca; Endocrinology and Nutrition Section (MB, AO, YGD, FJN), and Infectious Diseases and Tropical Medicine Unit (AF, JLPA), Internal Medicine Service, Hospital Universitario Insular of Gran Canaria, Gran Canaria; Department of Medical and Surgical Sciences (MB, AAM, CCR, RB, FJN, JLPA), Health Sciences Faculty, University of Las Palmas of Gran Canaria, Gran Canaria; and Internal Medicine Service II (AAM), Clínica Puerta de Hierro, Madrid, Spain
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Clifford V, Wadsley J, Jenner B, Buttery JP. Mumps vaccine associated orchitis: Evidence supporting a potential immune-mediated mechanism. Vaccine 2010; 28:2671-3. [PMID: 20085834 DOI: 10.1016/j.vaccine.2010.01.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Revised: 12/21/2009] [Accepted: 01/06/2010] [Indexed: 11/29/2022]
Abstract
We report 3 cases of orchitis following vaccination with mumps-measles-rubella (MMR) vaccine, two with an onset within 3 days following vaccination. Orchitis is a common complication of mumps infection, particularly in post-pubertal males, and is also recognized as a very rare complication of mumps vaccination. These cases, discussed together with a comprehensive review of the existing literature regarding post-vaccine orchitis, highlight uncertainty regarding the pathogenesis of post-vaccine orchitis.
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Affiliation(s)
- Vanessa Clifford
- Infectious Diseases Unit, Department of General Medicine & Murdoch Childrens Research Institute, Royal Children's Hospital Melbourne, Parkville, Victoria 3052, Australia.
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2008. [DOI: 10.1002/pds.1492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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