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Felip E, Pradenas E, Romeo M, Marfil S, Trinité B, Urrea V, Hernández A, Ballana E, Cucurull M, Mateu L, Massanella M, Clotet B, Morán T, Blanco J. Impact of chemotherapy and/or immunotherapy on neutralizing antibody response to SARS-CoV-2 mRNA-1237 vaccine in patients with solid tumors. Mol Oncol 2023; 17:686-694. [PMID: 36495129 PMCID: PMC9877816 DOI: 10.1002/1878-0261.13359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/02/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Patients with solid tumors have been a risk group since the beginning of the SARS-CoV-2 pandemic due to more significant complications, hospitalizations or deaths. The immunosuppressive state of cancer treatments or the tumor itself could influence the development of post-vaccination antibodies. This study prospectively analyzed 89 patients under chemotherapy and/or immunotherapy, who received two doses of the mRNA-1237 vaccine, and were compared with a group of 26 non-cancer individuals. Information on adverse events and neutralizing antibodies against the ancestral strain of SARS-CoV-2 (WH1) have been analyzed. Local reactions accounted for 65%, while systemic reactions accounted for 46% of oncologic individuals/cancer patients. Regarding the response to vaccination, 6.7% of cancer patients developed low neutralizing antibody levels. Lower levels of neutralizing antibodies between cancer and non-cancer groups were significant in individuals without previous SARS-CoV-2 infection, but not in previously infected individuals. We also observed that patients receiving chemotherapy or chemoimmunotherapy have significantly lower levels of neutralizing antibodies than non-cancer individuals. In conclusion, our study confirms the importance of prioritizing cancer patients receiving anticancer treatment in SARS-CoV-2 vaccination programs.
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Affiliation(s)
- Eudald Felip
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | | | - Margarita Romeo
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | | | | | | | - Ainhoa Hernández
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Ester Ballana
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Germans Trias i Pujol Research Institute (IGTP)BadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
| | - Marc Cucurull
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Lourdes Mateu
- Infectious Diseases DepartmentHospital Universitari Germans Trias i PujolBadalonaSpain
- Fundació Lluita contra les InfeccionsHospital Universitari Germans Trias i PujolBadalonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Marta Massanella
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Bonaventura Clotet
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Julià Blanco
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Germans Trias i Pujol Research Institute (IGTP)BadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
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Bae E, Bae S, Vaysblat M, Abdelwahed M, Sarkar K, Bae S. Development of High-Grade Sarcoma After Second Dose of Moderna Vaccine. Cureus 2023; 15:e37612. [PMID: 37197108 PMCID: PMC10184721 DOI: 10.7759/cureus.37612] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2023] [Indexed: 05/19/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a disease characterized by predominantly respiratory symptoms, which can progress to respiratory failure. Due to the novelty of the vaccines, it is difficult to assess if there are any associated long-term side effects. Here, we present a case of an elderly female who received the Moderna COVID-19 vaccine and developed a high-grade sarcoma at the site of the injection. A 73-year-old female with a past medical history of hypertension, hyperlipidemia, and renal angiomyolipoma status post resection in 2019 presented with worsening right upper arm swelling for the past two weeks. She noticed the swelling two to four days after receiving her second dose of the Moderna vaccine within 1 cm from the prior injection site. Physical examination was remarkable for a 6 cm, circular, mobile, soft mass present in the right upper arm. MRI with and without contrast revealed a 5.2 cm soft tissue mass overlying the triceps region with irregular features concerning for malignancy. Fine needle aspiration revealed pathologic characteristics indicative of high-grade sarcoma. The patient ultimately had resection of the mass four months after the initial visit and was diagnosed as having grade 3, stage IIIA undifferentiated, pleomorphic high-grade sarcoma. Herein, we present a case demonstrating the development of high-grade sarcoma at the injection site in an elderly female patient within days of receiving the second dose of the Moderna COVID-19 vaccine. Currently, it is unclear whether there is a true association between the vaccines and malignancy or inflammatory response exacerbating underlying malignancy. This case highlights the necessity to investigate and be aware of such rare, adverse complications that may be associated with the novel COVID-19 vaccinations to guide physicians in their differential diagnosis.
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Affiliation(s)
- Edward Bae
- Internal Medicine, State University of New York (SUNY) Downstate Health Sciences University, College of Medicine, Brooklyn, USA
| | - Suhwoo Bae
- Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA
| | - Michael Vaysblat
- Internal Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA
| | - Mohammed Abdelwahed
- Pathology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA
| | - Kumar Sarkar
- Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, USA
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Bhandari N, Chaudhary A, Acharya S, Acharya SS, Paudel K, Karmacharya RM, Vaidya S, Kunwar K, Bhatt S. Supraventricular tachycardia and deep vein thrombosis following Moderna vaccination: A case series. Clin Case Rep 2023; 11:e7065. [PMID: 36968349 PMCID: PMC10030682 DOI: 10.1002/ccr3.7065] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/28/2022] [Accepted: 12/30/2022] [Indexed: 03/24/2023] Open
Abstract
There have been reports of deep vein thrombosis and supraventricular tachycardia following the Moderna vaccination. The timing of SVT and DVT just after vaccination in our case series could suggest possible temporal relationships to the vaccination. But further studies are needed to establish such evidence.
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Affiliation(s)
- Niroj Bhandari
- Department of SurgeryKathmandu University School of Medical SciencesDhulikhelNepal
| | - Aashutosh Chaudhary
- Kathmandu University School of Medical SciencesDhulikhel HospitalDhulikhelNepal
| | - Suyash Acharya
- Kathmandu University School of Medical SciencesDhulikhel HospitalDhulikhelNepal
| | | | - Kusum Paudel
- Department of MedicineKathmandu University School of Medical SciencesDhulikhelNepal
| | - Robin Man Karmacharya
- Cardio‐Thoracic and Vascular Surgery Unit, Department of SurgeryKathmandu University School of Medical SciencesDhulikhelNepal
| | - Satish Vaidya
- Cardio‐Thoracic and Vascular Surgery Unit, Department of SurgeryKathmandu University School of Medical SciencesDhulikhelNepal
| | - Kajol Kunwar
- Kathmandu University School of Medical SciencesDhulikhel HospitalDhulikhelNepal
| | - Swechha Bhatt
- Kathmandu University School of Medical SciencesDhulikhel HospitalDhulikhelNepal
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Namous NA, Kushner D, Dadparvar S. Bilateral Axillary Nodal Uptake on 99m Tc-White Blood Cell Study Secondary to COVID-19 mRNA Vaccination. Clin Nucl Med 2023; 48:250-252. [PMID: 36127779 PMCID: PMC9907353 DOI: 10.1097/rlu.0000000000004394] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 07/27/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT A 77-year-old man with a history of chronic lower back pain, and prior spinal fusion surgery X2 was referred for 99m Tc-WBC Study for evaluation of worsening back pain and cervical radiculopathy to rule out any signs of infection. The patients white blood cells were tagged with 99m Tc-HMPAO (hexamethylpropylene amine oxime), and planar and SPECT/CT imaging was performed at 4 and 24 hours. 99m Tc-WBC Study showed no abnormal isotope localization in the spine; however, there was an incidental finding of bilateral increased soft tissue uptake in axillary lymph nodes. Medical history revealed intramuscular injection of second and third dose of Moderna mRNA COVID-19 vaccine in bilateral deltoids approximately 11 and 5 months before scan.
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Affiliation(s)
| | - Daniel Kushner
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Temple University Hospital, Philadelphia, PA
| | - Simin Dadparvar
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology, Temple University Hospital, Philadelphia, PA
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Tseng PH, Chuang SH, Pan Y, Shih HJ, Chang CP, Huang SH. Gross hematuria and IgA nephropathy flare-up following the first dose of Moderna vaccine: A case report. Medicine (Baltimore) 2022; 101:e32524. [PMID: 36595987 PMCID: PMC9803522 DOI: 10.1097/md.0000000000032524] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Since the mass vaccination for COVID-19, several case reports indicated the risk of autoimmune disease flare-ups after the vaccination. Among them, COVID-19 vaccine-induced glomerular diseases have drawn attention worldwide. The cases demonstrating the association between the mRNA vaccine and IgA nephropathy (IgAN) exacerbation had been noticed. Mostly mentioned, the flare-ups usually occurred after the second dose. METHODS We present a Taiwanese female with IgAN who developed gross hematuria within only six hours after the first dose of the Moderna vaccine. RESULTS Six hours after the first dose of Moderna vaccine on 8 June 2021, the patient developed gross hematuria and significantly decreased urine output. All symptoms resolved spontaneously on the fifth day after the vaccination without any intervention. On the fourth day after the vaccination, the patient were able to back to her original condition. CONCLUSION This was an intriguing case of IgAN flare-up following the first dose of mRNA-based COVID-19 vaccination.
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Affiliation(s)
- Po-Hung Tseng
- Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, TaiwanROC
| | - Shu-Han Chuang
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Yueh Pan
- Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, TaiwanROC
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
| | - Hung-Jen Shih
- Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, TaiwanROC
- Department of Urology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Chin-Pao Chang
- Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, TaiwanROC
| | - Sheng-Hsien Huang
- Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, TaiwanROC
- * Correspondence: Sheng-Hsien Huang, MD, Address: No. 135, Nanxiao St., Changhua City, Changhua County 500209, Taiwan, ROC (e-mail: )
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Abstract
Autoimmune endocrine diseases have been reported after influenza and the human papillomavirus vaccine, but there is limited data on autoimmune diseases after coronavirus disease 2019 (COVID-19) vaccination. Our report is about a 42-year-old Caucasian male and a 68-year-old Caucasian female who developed Graves' disease after receiving Moderna (Moderna, Inc., Cambridge, Massachusetts, United States) and Johnson & Johnson (Johnson & Johnson, New Brunswick, New Jersey, United States) vaccines, respectively. Both patients had no previous autoimmune thyroiditis and had normal thyroid function but developed hyperthyroidism characterized by suppressed thyroid-stimulating hormone (TSH), elevated free T4 level, and TSH receptor antibodies after vaccination. COVID-19 vaccines, either mRNA-based (Moderna) or non-mRNA-based (Johnson & Johnson), can cause Graves' disease. The clinical manifestations are similar to Graves' disease but without ocular manifestations.
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Affiliation(s)
- Gurdeep Singh
- Endocrinology, Diabetes and Metabolism, Our Lady of Lourdes Memorial Hospital, Binghamton, USA
| | - Timothy Howland
- Internal Medicine/Endocrinology, Our Lady of Lourdes Memorial Hospital, Binghamton, USA
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Abstract
SARS-CoV-2, which originated in China in late 2019, has spread rapidly resulting in a global pandemic. Multiple vaccines have been developed to help prevent COVID-19 infection. Similar to other vaccines, common side effects including fever, fatigue, myalgias have occurred; however, episodes of more serious side effects have been noted. One such potentially serious sequalae is vaccine-induced thrombocytopenia (VITT), an autoimmune-mediated phenomenon hypothesized to occur due to molecular mimicry and the production of platelet PF4 antibodies, ultimately leading to thrombocytopenia and easy bruising. In this report, we present the case of a 34-year-old, otherwise, healthy female who presented with easy bruising and thrombocytopenia following completion of the two-dose Moderna COVID-19 vaccine, suspicious for a diagnosis of VITT. The patient was managed conservatively with steroids. Steroids and intravenous immune globulin therapy have been reported in the literature. This report highlights that VITT should be considered in the differential diagnosis for patient presenting with increased bruising in the setting of recent COVID-19 vaccine administration, and furthermore highlights the diagnostic workup and management options for such patients.
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Affiliation(s)
| | - Shiavax Rao
- MedStar Health Internal Medicine Residency, Baltimore, MD, USA
| | - Pallavi Lakra
- MedStar Health Internal Medicine Residency, Baltimore, MD, USA
| | - Natalia Nacu
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA
| | - Christopher Haas
- Department of Medicine, MedStar Union Memorial Hospital, Baltimore, MD, USA.,Department of Medicine, MedStar Franklin Square Medical Center, Baltimore, MD, USA.,Department of Medicine, MedStar Harbor Hospital, Baltimore, MD, USA.,Department of Medicine, Georgetown University Medical Center, Washington, DC, USA
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Zaveri S, Tagliaferri AR, Woldemariam S, Aron P, Palacios C, Melki G, Michael P. A Case of Multifactorial Viral Myocarditis. Cureus 2021; 13:e18950. [PMID: 34812324 PMCID: PMC8604421 DOI: 10.7759/cureus.18950] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
We present a case of viral myocarditis in the setting of Coxsackievirus and coronavirus disease 2019 (COVID-19) infection. This case is unique as there were two underlying active infections that could have caused the patient's myocarditis. Though both viruses have been shown to cause myocarditis, it was difficult to differentiate the exact etiology in this particular case. The unique nature of this case presents the opportunity to explore whether further diagnostic workup is warranted.
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Affiliation(s)
- Sahil Zaveri
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | | | - Sara Woldemariam
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Polina Aron
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Carlos Palacios
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
| | - Gabriel Melki
- Gastroenterology, St. Joseph's University Medical Center, Paterson, USA
| | - Patrick Michael
- Internal Medicine, St. Joseph's University Medical Center, Paterson, USA
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9
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Abstract
Since the start of the pandemic, to date, around 180 million cases have been diagnosed with COVID-19 worldwide with an estimated 3.9 million death toll. Mass vaccination has taken place to control spread of infection with the most commonly used vaccines being Pfizer-BioNTech and Moderna. However, the adverse events associated with vaccination have not been fully investigated. Of concern are some serious cardiovascular events such as myocarditis, pericarditis or perimyocarditis development post-vaccination. In this report, we present an unusual case of acute perimyocarditis and pericardial effusion 10 days following the second dose of Moderna COVID-19 vaccination in Qatar. At the time of presentation, the patient presented with non-specific symptoms of headache, diarrhea, vomiting, lethargy and dehydration. COVID-19 polymerase chain reaction (PCR) was negative. Once admitted to the emergency department, she started to deteriorate with very low blood pressure readings reaching 40/33 mmHg which was treated with aggressive fluid resuscitation. After 5.5 liters of intravenous fluids, echocardiography and electrocardiogram (ECG) were performed. Findings were consistent with pericardial effusion, signs of impending cardiac tamponade and acute perimyocarditis. Cardiac biomarkers including troponin T and pro-brain natriuretic peptide (BNP) were elevated. Hospital course was complicated with cardiac arrest, acute kidney injury, disseminated intravascular coagulation (DIC) and hemodynamic instability. Eventually, the patient recovered after a three-week hospital stay and was discharged on non-steroidal anti-inflammatory medication (NSAIDs). This case report highlights the hospital course and outcome linking the second dose of Moderna vaccination and the development of perimyocarditis.
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Affiliation(s)
- Fatima Khogali
- Medical Research Center, Hamad Medical Corporation, Doha, QAT
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McCarthy AD, McGoldrick DJ, Holubeck PA, Cohoes C, Bilek LD. Social Data: An Underutilized Metric for Determining Participation in COVID-19 Vaccinations. Cureus 2021; 13:e16379. [PMID: 34408934 PMCID: PMC8361817 DOI: 10.7759/cureus.16379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2021] [Indexed: 11/16/2022] Open
Abstract
Many measures have been taken since late 2019 to combat the coronavirus disease (COVID-19) pandemic. National, state, and local governments employed precautions, including mask mandates, stay-at-home orders, and social distancing policies, to alleviate the burden on healthcare workers and slow the spread of the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) virus until an efficacious vaccine was made widely available. By early spring of 2021, three effective and well-tolerated SARS-CoV-2 vaccines emerged and underwent broad distribution. Throughout the course of the COVID-19 vaccination campaign, several key logistical and psychological issues surfaced. Of these, access to vaccines and vaccination hesitancy are cited as two substantial hindrances towards vaccination. Noting the demand for the SARS-CoV-2 vaccine and its highly sensitive storage requirements, accurate dose allocation is critical for vaccinating the population quickly and successfully. Here, we propose the use of social data as a tool to predict vaccination participation by correlating Google searches with state-level daily vaccination. We identified a temporal and regionally-ubiquitous Google search syntax that broadly captures daily vaccination trends. By correlating trends in the search syntax with daily vaccination rates, we were able to quantify the correlation and identify optimal lag periods between Google searches and daily vaccination. This work highlights the importance of analyzing social data as a metric to effectively arrange vaccination roll-outs, identify voluntary vaccination participation, and identify inflection points in vaccination participation. In addition, social data assessments can help direct dose allocation, identify geographic areas that may seek, but lack, access to the vaccines, and actively prepare for fluctuations in vaccination demands.
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Affiliation(s)
- Alec D McCarthy
- Department of Surgery - Transplant, University of Nebraska Medical Center, Omaha, USA
| | - Daniel J McGoldrick
- Department of Computer Science, California State University, Monterey Bay, Seaside, USA
| | - Phil A Holubeck
- Department of Regenerative Medicine, College of Medicine, University of Nebraska Medical Center, Omaha, USA
| | - Cavan Cohoes
- Department of Mathematics, Columbia University, New York, USA
| | - Laura D Bilek
- College of Allied Health Professionals, University of Nebraska Medical Center, Omaha, USA
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Abstract
Myasthenia gravis is a rare disease of the neuromuscular junction subsequently affecting the bulbar, respiratory, and extremity skeletal muscles. It is an autoimmune disease in which antibodies target the acetylcholine receptor (AChR), preventing transmission of the excitatory cascade during muscle contraction. Myasthenia gravis is typically well controlled using acetylcholinesterase inhibitors, steroids, immunosuppressant agents, and/or thymectomies. However, exacerbations can be induced by infection or medications. This is particularly important during the coronavirus disease 2019 (COVID-19) pandemic in which myasthenia gravis patients have been known to have poorer outcomes. We report a very rare presentation of a myasthenia gravis crisis induced by the Moderna COVID-19 vaccine.
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Affiliation(s)
- Ariana R Tagliaferri
- Radiology, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, USA.,Internal Medicine, St. Joseph's Regional Medical Center, Paterson, USA
| | | | - Moh'd Hazem Azzam
- Pulmonology and Critical Care, St. Joseph's Regional Medical Center, Paterson, USA
| | - William Grist
- Pulmonology and Critical Care, St. Joseph's Regional Medical Center, Paterson, USA
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