1
|
Chamboux M, Simon C, Beau-Salinas F, Maurier A, Agier MS, Thillard EM, Largeau B, Jonville-Bera AP. Peripheral facial palsy post SARS-CoV-2 vaccine: A regional pharmacovigilance cases series. Therapie 2023; 78:705-709. [PMID: 36849281 PMCID: PMC9933875 DOI: 10.1016/j.therap.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/01/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023]
Abstract
Peripheral facial palsy (PFP) is a rare adverse reaction identified from clinical trials of coronavirus disease 2019 (COVID-19) vaccines (messenger ribonucleic acid [mRNA] and viral vector). Few data are available on their onset patterns and risk of recurrence after re-injection of a COVID-19 vaccine; the objective of this study was to describe PFP cases attributed to COVID-19 vaccines. All cases of facial paralysis reported to the Regional Pharmacovigilance Center of Centre-Val de Loire area between January and October 2021, in which the role of a COVID-19 vaccine was suspected, were selected. Based on initial data and following additional information requested, each case was reviewed and analyzed to include only confirmed cases of PFP for which the role of the vaccine could be retained. From the 38 cases reported, 23 were included (15 excluded because of diagnosis not retained). They occurred in 12 men and 11 women (median age of 51 years). The first clinical manifestations occurred with a median time of 9 days after COVID-19 vaccine injection, and the paralysis was homolateral to the vaccinated arm in 70%. The etiological workup, always negative, included brain imaging (48%), infectious serologies (74%) and Covid-19 PCR (52%). Corticosteroid therapy was prescribed for 20 (87%) patients, combined with aciclovir in 12 (52%). At 4-month follow-up, clinical manifestations had regressed completely or partially in 20 (87%) of the 23 patients (median time of 30 days). From them 12 (60%) received another dose of COVID-19 vaccine and none had a recurrence and the PFP regressed despite the second dose in 2 of the 3 patients not fully recovered at 4 months. The potential mechanism of PFP after COVID-19 vaccine, which don't have a specific profile, is probably the interferon-γ. Moreover, the risk of recurrence after a new injection appears to be very low, which makes it possible to continue the vaccination.
Collapse
Affiliation(s)
- Morgane Chamboux
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre-Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Corinne Simon
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre-Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Frédérique Beau-Salinas
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre-Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Anaïs Maurier
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre-Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Marie Sara Agier
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre-Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Eve Marie Thillard
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre-Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Bérenger Largeau
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre-Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Annie Pierre Jonville-Bera
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre-Val de Loire, University Hospital of Tours, 37000 Tours, France.
| |
Collapse
|
2
|
Chamboux M, Simon C, Beau-Salinas F, Maurier A, Agier MS, Thillard EM, Largeau B, Jonville-Bera AP. Response to Letter "Only blames SARS-CoV-2 vaccination for facial palsy after alternative etiologies have been ruled out". Therapie 2023; 78:464-465. [PMID: 37277229 PMCID: PMC10210817 DOI: 10.1016/j.therap.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Morgane Chamboux
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Corinne Simon
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Frédérique Beau-Salinas
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Anaïs Maurier
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Marie Sara Agier
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Eve Marie Thillard
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Bérenger Largeau
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre Val de Loire, University Hospital of Tours, 37000 Tours, France
| | - Annie-Pierre Jonville-Bera
- Department of Pharmacosurveillance, Pharmacovigilance Regional Center of Centre Val de Loire, University Hospital of Tours, 37000 Tours, France.
| |
Collapse
|
3
|
Collercandy N, Thorey C, Diot E, Grammatico-Guillon L, Thillard EM, Bernard L, Maillot F, Lemaignen A. When to investigate for secondary hyperhidrosis: data from a retrospective cohort of all causes of recurrent sweating. Ann Med 2022; 54:2089-2101. [PMID: 35903938 PMCID: PMC9455328 DOI: 10.1080/07853890.2022.2102675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Identification of underlying diseases is crucial for secondary hyperhidrosis management, but data are lacking to guide appropriate investigation.Objective: To describe aetiologies of recurrent sweating in a hospital setting and the diagnostic performance parameters of their respective clinical/biological features.Patients and Methods: We performed a monocentric evaluative study in a tertiary care centre. Patients with recurrent generalised sweating were selected via the Clinical Data Warehouse (CDW) by screening all electronic hospital documents from the year 2018 using a keyword-based algorithm. All in and out-patients aged ≥ 18 years having reported recurrent sweating for at least 2 weeks in 2018 were included, with a minimum one-year follow-up after symptoms' onset.Results: A total of 420 patients were included. Over 130 different aetiologies were identified; 70 patients (16.7%) remained without diagnosis. Solid organ cancers (14.3% with 13 lung cancers), haematologic malignancies (14.0% with 35 non-Hodgkin's lymphomas) and Infectious Diseases (10.5% including 13 tuberculosis) were the most frequent diagnoses. Other aetiologies were gathered into inflammatory (16.9%) and non-inflammatory (27.6%) conditions. To distinguish non-inflammatory and undiagnosed hyperhidrosis from other causes, fever had a specificity of 94%, impaired general condition a sensitivity of 78%, and C-reactive protein (CRP) > 5.6 mg/l a positive predictive value of 0.86. Symptoms' duration over 1 year was in favour of non-infectious and non-malignant causes (94% specificity).Conclusions: We identified fever, impaired general condition, duration, and CRP as helpful orientation parameters to assess the need for complementary explorations for hyperhidrosis. The study provides a diagnostic algorithm for the investigation of recurrent sweating.KEY MESSAGESIn a hospital setting, malignancies and infections are the most frequently associated diseases, but 1/5 remain without diagnosis.Fever is a specific but not sensitive sign to distinguish inflammatory conditions.Over 1 year duration of symptoms significantly reduce the probability of malignancy or infection as the underlying diagnosis.
Collapse
Affiliation(s)
- Nived Collercandy
- Service de Médecine interne et Maladies infectieuses, Centre Hospitalier Universitaire de Tours, Tours, France.,Service de Médecine interne et Immunologie clinique, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Camille Thorey
- Service de Médecine interne et Maladies infectieuses, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Elisabeth Diot
- Service de Médecine interne et Immunologie clinique, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Leslie Grammatico-Guillon
- Service d'Information Médicale, Epidémiologie et Economie de la Santé (SIMEES, Centre de données cliniques), Centre Hospitalier Universitaire de Tours, Tours, France.,Université de Tours, Tours, France
| | - Eve Marie Thillard
- Centre Régional de Pharmacovigilance et d'Information sur le Médicament, Centre Val de Loire, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Louis Bernard
- Service de Médecine interne et Maladies infectieuses, Centre Hospitalier Universitaire de Tours, Tours, France.,Université de Tours, Tours, France
| | - François Maillot
- Service de Médecine interne et Immunologie clinique, Centre Hospitalier Universitaire de Tours, Tours, France.,Université de Tours, Tours, France
| | - Adrien Lemaignen
- Service de Médecine interne et Maladies infectieuses, Centre Hospitalier Universitaire de Tours, Tours, France.,Université de Tours, Tours, France
| |
Collapse
|
4
|
Fillon A, Sautenet B, Barbet C, Moret L, Thillard EM, Jonville-Béra AP, Halimi JM. De novo and relapsing necrotizing vasculitis after COVID-19 vaccination. Clin Kidney J 2021; 15:560-563. [PMID: 35211310 PMCID: PMC8862065 DOI: 10.1093/ckj/sfab285] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
We describe 5 cases of severe necrotizing vasculitis following the RNA-based vaccine for SARS-COV2, including 4 relapsing ANCA vasculitis, 27 days (1-60) after vaccination and 1 patient with quiescent chronic hepatitis B and de novo polyarteritis nodosa (PAN) 21 days after vaccination. Ten other cases were reported to the French national pharmacovigilance database: 6 patients with ANCA-associated vasculitis and 4 patients with PAN (first symptoms 19 days on average after vaccination). Five of these 10 patients developed kidney dysfunction. In conclusion, COVID-19-vaccines can be associated with de novo or recurrent ANCA vasculitis or PAN. Attention should be paid to patients with known ANCA vasculitis or patients with history of hepatitis B infection.
Collapse
Affiliation(s)
- Alexandre Fillon
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
| | - Benedicte Sautenet
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
- SPHERE INSERM 1246, Université de Tours, Université de Nantes, Tours, France
- Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), France
| | - Christelle Barbet
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
| | - Léa Moret
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
| | - Eve Marie Thillard
- CHRU de Tours, Centre Régional de Pharmacovigilance Centre Val de Loire, Tours, France
| | - Annie Pierre Jonville-Béra
- SPHERE INSERM 1246, Université de Tours, Université de Nantes, Tours, France
- CHRU de Tours, Centre Régional de Pharmacovigilance Centre Val de Loire, Tours, France
| | - Jean Michel Halimi
- Service de néphrologie-hypertension artérielle, dialyses, transplantation rénale, CHU Bretonneau, Tours, France
- Investigation Network Initiative Cardiovascular and Renal Clinical Trialists (INI-CRCT), France
- EA 4245, Université François-Rabelais, Tours, France
| |
Collapse
|