Adult-Onset Still’s Disease After the ChAdOx1 nCoV-19 Vaccine

AlQudari, Elham A; Alabdan, Lulwah; Alkhathami, Abdulla A; Alotaibi, Mohammed; Alhamzi, Hanan A

doi:10.7759/cureus.21279

Cited by 7 publications

(10 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Among patients with given diagnosis of inflammatory arthritis, adult‐onset Still's disease (AoSD) accounts for the most common diagnosis (10 cases). 9 , 10 , 11 , 12 , 13 , 14 , 15 Other diagnoses include polyarthralgia and myalgia syndrome (PaMS, 5 cases), 16 undifferentiated connective tissue disease (UCTD, 4 cases), 17 immunoglobulin A (IgA) vasculitis (IgAV, or Henoch‐Schönlein purpura [HSP], 4 cases), 18 , 19 , 20 reactive arthritis (ReA, 3 cases), 21 , 22 systemic lupus erythematosus (SLE, 3 cases), 23 , 24 , 25 rheumatoid arthritis (RA, 1 cases), 26 and so on. Polyarthritis, defined as 4 or more joints involvment, 8 accounts for 23 cases, and the remaining 10 patients are classified as mono‐ or oligoarthritis (the remaining 6 cases are not clearly classified).…”

Section: Resultsmentioning

confidence: 99%

“…Among 10 patients (6 females and 4 males, average age 38.6 ± 12.4 years) with post‐vaccination AoSD, 5 cases were following by AZD‐1222, 4 cases by BNT162, and 1 case by mRNA‐1273. Manifestation of polyarthritis (6 cases) 9 , 11 , 13 , 15 is more common than oligo‐ or monoarthritis (4 cases) 10 , 12 , 13 , 14 in patients with post‐vaccination AoSD, and the adjusted mean time interval between events is 9.8 ± 5.7 days (Table 4 ). Most patients have characteristic features of AoSD including spiking fever, Still's rash, lymphadenopathy, and pleurisy with effusion, and 2 cases had complications of hyperinflammatory syndromes 12 , 13 (Table S1 ).…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

New‐onset inflammatory arthritis after COVID‐19 vaccination: A systematic review

Chen

2022

Int J of Rheum Dis

View full text Add to dashboard Cite

Aim To analyze the clinical patterns of new‐onset inflammatory arthritis after COVID‐19 vaccination among patients without pre‐existing rheumatic or autoimmune diseases. Method Case reports and series of new‐onset inflammatory arthritis after COVID‐19 vaccination were collected before April 2022. Clinical characteristics including diagnosis, age, gender, vaccine types, time interval between events, joint involvement (poly‐ or oligo−/monoarthritis), and laboratory data reflecting inflammatory status were sorted and P values between these parameters are calculated with independent sample Student's t test or 2 × 2 Fisher's exact test. Results Among 39 cases with new‐onset post‐vaccination arthritis including 25 females and 13 males (1 unknown), the most common diagnosis is adult‐onset Still's disease (AoSD, 10 cases), and the most common vaccine types are BNT162b2 (16 cases) and AZD‐1222 (or ChAdOx1‐nCoV19, 15 cases). Sub‐analysis reveals that post‐vaccination polyarthritis is more common among females ( P = .016, by 2 × 2 Fisher's exact test, compared with male patients) and older patients ( P = .006, by Student's t test). The C‐reactive protein level is significantly higher in cases with post‐vaccination inflammatory polyarthritis than oligoarthritis ( P = .029), as well as in cases with AoSD than other causes of post‐vaccination arthritis ( P = .004). However, serum level of erythrocyte sedimentation rate in patients with post‐vaccination AoSD are independent of other clinical variables in the analysis. Conclusion New‐onset post‐vaccination polyarthritis are more common in females and older patients. Although COVID‐19 vaccines may lead to inflammatory arthritis, the benefits of vaccination substantially outweigh the potential risks of such serious adverse effects due to their rarity.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

New‐onset inflammatory arthritis after COVID‐19 vaccination: A systematic review

Chen

2022

Int J of Rheum Dis

View full text Add to dashboard Cite

show abstract

“…However, the pathway linking AOSD and COVID-19 vaccination requires further study, and similar cases need to be reviewed to determine the possible mechanism. Therefore, we compared a few similar cases diagnosed as AOSD as a consequence of COVID-19 vaccination [ 5 , 6 , 7 , 8 , 9 , 10 ] ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

Adult-Onset Still’s Disease following Coronavirus 2 (SARS-CoV-2) Vaccination: A Case Report

2022

View full text Add to dashboard Cite

In recent years, during the ravages of COVID-19, a variety of vaccines have been developed and are now on the market. However, although these new vaccines have undergone various trials, there are still many unknown side effects. We report a case of a 30-year-old woman who presented with general weakness, sore throat, generalized skin rashes, symmetrical arthralgia, and persistent fever of up to 40 °C with onset 16 days after receiving the Moderna COVID-19 vaccine. Adult-onset Still’s disease (AOSD) was diagnosed according to Yamaguchi’s criteria after excluding the feasibility of infectious diseases, autoimmune diseases, and malignancies. In particular, her responses to glucocorticoids and naproxen were significant and inversely proportional to her use of empirical antibiotics in the initial stage of treatment. We studied some similar cases of AOSD, which also considered the adverse effects of COVID-19 vaccination and suggested the immunogenicity and possibility of inflammatory responses related to COVID-19 vaccination.

show abstract

“…Details of the clinical features, laboratory findings, and treatment outcomes of the previously reported 10 cases [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ] and this present one are shown in Table 1 . The patient in this case report had received two doses of Sinovac followed by one of viral vector ChAdOx1 (AstraZeneca]) vaccine, which caused the onset of AOSD-like syndrome, whereas five of the other patients developed AOSD-like syndrome after the first dose of ChAdOx1 (AstraZeneca).…”

Section: Review Of the Literaturementioning

confidence: 92%

“…Of these autoimmune syndromes, AOSD-like syndrome has rarely been described. It is interesting that a PubMed literature search, performed up until March 2022, identified seven articles (10 cases) of AOSD-like syndrome following COVID-19 vaccination [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Adult-Onset Still’s Disease-like Syndrome following COVID-19 Vaccination: A Case Report and Review of the Literature

et al. 2022

View full text Add to dashboard Cite

Adult-onset Still’s disease (AOSD)-like syndrome has rarely been reported as a complication of COVID-19 vaccination. This study reports a 31-year-old female patient who presented with fever, myalgia, arthralgia, pleuropericarditis, leukocytosis, and transaminitis following ChAdOx1 vaccination, and met Yamaguchi’s criteria. A PubMed literature search, performed up until March 2022, identified 10 such cases. A total of 11 cases, including the one in this report, developed AOSD-like syndrome after administration of the viral vector (ChAdOx1) vaccine (six patients) and mRNA vaccine (five patients: BNT162b2 in four and mRNA-1273 in one). There were four male and seven female patients, with their median (Q1, Q3) age and the onset of symptoms after vaccination being 36 years (29, 45) and 10 days (6, 13), respectively. Fever (100%), arthralgia/arthritis (90.9%), skin rashes (81.8%), and sore throat (81.8%) were the main clinical findings. Pericarditis (45.5%), myocarditis/cardiac dysfunction (36.4%), pleuritis (54.6%), and pulmonary infiltrations (36.4%) were also common. One patient developed macrophage activation syndrome. One patient responded well to non-steroidal anti-inflammatory drugs, and the other six showed a good response to high-dose corticosteroids alone. Of the remaining four patients, who showed partial responses to high dose corticosteroids, showed good responses to biological agents. AOSD-like syndrome following COVID-19 vaccination shared many similar clinical features and treatment outcomes to those of idiopathic AOSD (but with a higher prevalence of cardiopulmonary involvement in the former). Physicians should be aware of this extremely rare complication to achieve early diagnosis and provide proper management.

show abstract

Adult-Onset Still’s Disease After the ChAdOx1 nCoV-19 Vaccine

Cited by 7 publications

References 10 publications

New‐onset inflammatory arthritis after COVID‐19 vaccination: A systematic review

New‐onset inflammatory arthritis after COVID‐19 vaccination: A systematic review

Adult-Onset Still’s Disease following Coronavirus 2 (SARS-CoV-2) Vaccination: A Case Report

Adult-Onset Still’s Disease-like Syndrome following COVID-19 Vaccination: A Case Report and Review of the Literature

Contact Info

Product

Resources

About