Acute Severe Ulcerative Colitis After mRNA Coronavirus Disease 2019 Vaccination: Can mRNA Vaccines Unmask Inflammatory Bowel Diseases?

Ak, Çağatay; Sayar, Süleyman; Adali, Güpse; Özdil, Kamil

doi:10.14309/crj.0000000000000806

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…Several case reports mentioned UC triggered by messenger RNA (mRNA) vaccines such as BNT162b2 and mRNA-1273, and Çağatay and colleagues believed that the BNT162b2 vaccine may have triggered a worsening of UC by activating nuclear factor-κB and interferon-alpha. [9][10][11] However, subsequent presentation of UC combined with arthropathy after receiving protein subunit vaccine as MVC-COVI1901 vaccine has not been previously reported. We speculate that the pathogenesis of this case could be correlated to the components of the MVC-COVI1901 vaccine (spike protein S-2P adjuvanted with CpG 1018 and aluminum hydroxide).…”

Section: Discussionmentioning

confidence: 99%

Case report of new‐onset ulcerative colitis after MVC‐COVI1901 vaccine injection for SARS‐CoV‐2

2023

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A 23‐year‐old man suffered from diarrhea after receiving the MVC‐COVI1901 vaccine. The patient then presented to our emergency department due to swelling and pain in his right knee. Synovial effusion studies of the right knee revealed inflammation. Gram and acid‐fast stains reported negative results and no crystals were found under a polarized light microscope. During his hospitalization, the patient underwent a colonoscopy and computed tomography (CT) due to bloody stool. Pancolitis was suspected under colonoscopy and an abdominal CT scan supported our diagnosis showing wall thickening and mucosal enhancement. Pathology showed distorted crypt architecture and acute cryptitis with abscesses. After excluding other causes of ulcerative colitis (UC), the patient was diagnosed with MVC‐COV1901 vaccine‐related UC and inflammatory bowel disease arthropathy. Subsequent presentation of UC and inflammatory bowel disease‐related arthropathy after receiving the MVC‐COVI1901 vaccine has not previously been reported. We speculate that the pathogenesis could be correlated to the vaccine's components (spike protein S‐2P adjuvanted with CpG 1018 and aluminum hydroxide) through the combination of 2 effects: the activation of Toll‐like receptor (TLR) 4 by S‐2P, and the activation of TLR9 and expression of interleukin‐13 by CpG‐1018 adjuvant. In conclusion, it is remarkable that the MVC‐COVI1901 vaccine may lead to the incidence of autoinflammatory diseases such as UC.

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Section: Discussionmentioning

confidence: 99%

Case report of new‐onset ulcerative colitis after MVC‐COVI1901 vaccine injection for SARS‐CoV‐2

2023

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“…Recent studies have shown that COVID-19 infection is associated with the development of autoimmunity and can trigger multiple autoimmune diseases, ranging from organ-specific to systemic autoimmune and inflammatory diseases [ 8 ]. Multiple cases of de novo inflammatory bowel diseases following COVID-19 infection or vaccination have been reported [ 9 , 10 ]. As direct causation is difficult to prove, an association remains controversial.…”

Section: Discussionmentioning

confidence: 99%

Management of Ulcerative Colitis Flare-Ups in the Era of COVID-19

Mounsif¹,

Setouani²,

Nadi³

et al. 2022

Cureus

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Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) whose management depends on its severity, localization, and course. The coronavirus disease 2019 (COVID-19) pandemic has made the management of this disease more difficult, as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) routinely causes respiratory infection, but can also target the gastrointestinal tract. Multiple cases of de novo IBD, IBD flare-ups, and colitis have been associated with COVID-19 infection. We present the case of two patients, with a history of UC, who presented respectively a mild and a severe flare-up of their disease associated with COVID-19 infection.Regardless of recommendations, we decided to optimize the patient's treatment and obtained good clinical, biological, and endoscopic results. This report on the two cases suggests that remaining cautious and optimizing can be a good therapeutic alternative for these patients rather than modifying the treatment.

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“…COVID-19 vaccination status does not seem to have an influence on disease onset or evolution [89,90]. In the adult population, however, there are new cases of IBD with onset reported after a previous SARS-CoV-2 infection, most of them with severe evolution, reflecting another aspect of the intricate SARS-CoV-2-IBD relationship [97][98][99][100]. Oral prednisone, then infliximab due to worsening hematochezia.…”

Section: De Novo Pediatric Ibd Post Covid-19mentioning

confidence: 99%

Impact of COVID-19 on Pediatric Inflammatory Bowel Diseases—From Expectations to Reality

Trandafir,

Spoiala,

Ghiga

et al. 2024

JPM

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Viral infections have always been considered a threat to global health, with numerous outbreaks across time. Despite the relative recent experience with coronavirus-associated diseases such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), severe acute respiratory syndrome-2’s (SARS-CoV-2) continuous evolution displays a different behavior. With a tropism for both respiratory and digestive mucosa, coronavirus disease 2019 (COVID-19) and inflammatory bowel disease (IBD) seem to share a particular common background. Current literature offers evidence that viral alteration of the immune system, inflammatory intestinal tissue damage, increased intestinal permeability, incomplete viral clearance with viral antigen persistence, and intestinal dysbiosis, might explain SARS-CoV-2–IBD relationship in terms of etiopathogenesis and evolution. The hyperinflammatory state that both entities have in common explains the lack of success of current IBD therapy, raising the need for new personalized therapeutic options, with better outcomes for IBD and COVID-19 as well. This review aims to summarize the current available data on pediatric IBD evolution, management, and outcomes in the post-COVID period, with an emphasis on the particular aspects of the SARS-CoV-2–IBD relationship in children.

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Acute Severe Ulcerative Colitis After mRNA Coronavirus Disease 2019 Vaccination: Can mRNA Vaccines Unmask Inflammatory Bowel Diseases?

Cited by 6 publications

References 14 publications

Case report of new‐onset ulcerative colitis after MVC‐COVI1901 vaccine injection for SARS‐CoV‐2

Case report of new‐onset ulcerative colitis after MVC‐COVI1901 vaccine injection for SARS‐CoV‐2

Management of Ulcerative Colitis Flare-Ups in the Era of COVID-19

Impact of COVID-19 on Pediatric Inflammatory Bowel Diseases—From Expectations to Reality

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