A case of multisystem inflammatory syndrome (MIS-A) in an adult woman 18 days after COVID-19 vaccination

Stappers, Sofie; Ceuleers, Britt; Brusselen, Daan Van; Willems, Philippe; Tavernier, Brecht De; Verlinden, Anke

doi:10.1080/17843286.2021.1977899

Cited by 14 publications

(16 citation statements)

References 13 publications

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“…However, considering the time trend and onset, it seems more likely that vaccine-induced inflammation (Talotta, 2021) was the primary trigger initiating the reactions (notwithstanding that inflammation may in itself trigger autoimmunity) in the cases we present. Indeed, there have been reports of inflammation-mediated adverse neurological and other events post-COVID-19 vaccination, such as: reactive arthritis (An et al, 2021); Vogt-Koyanagi-Hara disease (Koong et al, 2021); peripheral and central nervous system inflammation and demyelination (AlKolfat et al, 2022;Camera et al, 2021;Khayat-Khoei et al, 2021); acute disseminated encephalomyelitis (Cao & Ren, 2021;Kania et al, 2021;Lazaro et al, 2021;Permezel et al, 2021;Rinaldi et al, 2021;Vogrig et al, 2021); chronic inflammatory demyelinating polyneuropathy (post-SARS-CoV-2 infection and vaccination) (Suri et al, 2021); and adult multisystem inflammatory syndrome (Stappers et al, 2021). Further, 27 cases of post-COVID-19 vaccination immune-mediated disease flares have been reported by Watad et al (2021), including one case of demyelination.…”

Section: Discussionmentioning

confidence: 99%

Vitamin B12 and D deficiency as cofactors of COVID-19 vaccine-induced chronic neurological adverse reactions: Two cases and a hypothesis

Carroll

Millar

Deans

2022

Preprint

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Background: The COVID-19 vaccines have been an essential measure to help reduce COVID-19-related injury and death. However, in some cases, vaccination has caused severe and chronic reactions, akin to post-acute sequelae of COVID-19 (long COVID). Cases: Here we present two cases (Case 1: male, age 43 years, Pfizer BNT162b2 vaccination; Case 2: female, age 30 years, Oxford-AstraZeneca ChAdOx1nCoV-19 vaccination) with severe neurological adverse reaction post-vaccine and concomitant vitamin B12 deficiency. Both cases presented with non-textbook symptomatology of vitamin B12 deficiency. Case 1 had full symptom resolution with vitamin B12 replacement therapy. In Case 2, frank vitamin D deficiency and chronically elevated D-dimer were also found. Case 2 is still undergoing replacement therapy and this manuscript will be updated as appropriate. Discussion: Vaccines, including the COVID-19 vaccines, are known to cause severe and/or chronic neurological reactions in rare cases. We support screening for vitamin B12 deficiency prior to vaccination in high-risk groups (e.g. those following an animal produce free diet), those suffering atypical/chronic vaccine reactions, and those with similar conditions, such as post-acute sequelae of COVID-19 (long COVID). A hypothesis is also presented demonstrating the links between vitamin B12 and vitamin D deficiency and other pathologies (e.g. mast cell activation disorders) that, if validated, could help explain some vaccine hyperreactions.

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Section: Discussionmentioning

confidence: 99%

Vitamin B12 and D deficiency as cofactors of COVID-19 vaccine-induced chronic neurological adverse reactions: Two cases and a hypothesis

Carroll

Millar

Deans

2022

Preprint

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“…However, in this case no precedent COVID-19 infection was identified, and the symptoms onset 12 days after SARS-Cov-2 vaccination strongly suggest a cause-effect relationship. Interestingly enough, albeit our patient needed hospitalization, he never appeared severely ill, differently from most cases of COVID-19 or vaccine-related MIS in children and adults [1] , [2] , [3] , [5] , [6] , [7] , [8] . In ours and in the other vaccine-related MIS, steroidal therapy and/or immunoglobulins proved to be efficacious, and no deaths were recorded.…”

Section: Discussionmentioning

confidence: 60%

“…The United States Centers for Diseases Control and Prevention is eagerly collecting data on this serious condition [4] . To date, such systemic reaction has been associated with vaccination against SARS-CoV-2 alone in a very few reports [5] , [6] , [7] , [8] . We describe a case that resembled MIS, after vaccination with Ad26.…”

Section: Introductionmentioning

confidence: 99%

Multisystem Inflammatory Syndrome after Ad26.COV2.S vaccination

Bova¹,

Vigna

Gentile

2022

IDCases

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Background The multisystem inflammatory syndrome (MIS) is a rare and sometime life-threatening post-infectious complication of coronavirus disease 2019 (Covid-19) in children and adults. To date, only a very few reports have associated such systemic reaction with SARS-CoV-2 vaccination. Case report we describe a case that resembled MIS, in a 46-year-old White man, 12 days after vaccination with Ad26. COV2. S vaccine (Johnson &Johnson/Janssen), a recombinant adenovirus serotype 26 vector encoding the SARS-CoV-2 spike glycoprotein. The patient experienced high grade fever, cutaneous rash, severe weakness, pericardial effusion and raised inflammatory markers, which met the criteria for definition of MIS. The symptoms improved with steroidal therapy. Conclusions Our case suggests that MIS could occur after SARS-CoV-2 vaccination.

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“…Therefore, it is difficult to determine in all these cases whether MIS was due to infection, vaccination or both. MIS‐V has been described following the first or second dose of Comirnaty (Pfizer), 3 , 4 , 5 Vaxzevria (AstraZeneca) 6 and BBIBP‐CorV (Sinopharm). 7 The timing between the most recent vaccination and onset of symptoms varied between hours 7 and 22 days.…”

Section: Discussionmentioning

confidence: 99%