COVID-19 vaccine-induced cellulitis and myositis

Ramalingam, Sathishkumar; Arora, Harkesh; Lewis, Susan; Gunasekaran, Kulothungan; Muruganandam, Maheswari; Nagaraju, Sivakumar; Padmanabhan, Priyesh

doi:10.3949/ccjm.88a.21038

Cited by 23 publications

(19 citation statements)

References 7 publications

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“…An extensive literature search of PubMed, Scopus, Web of Science, LitCovid, and Google Scholar was performed using the key words "Dermatomyositis," "myositis," "COVID-19," and "vaccine" ranging from December 2020 to December 8, 2021. It has produced six previous reported cases of post-COVD-19 vaccine myositis, 16 17 18 19 summarized in Table 2 . In 3 cases, myositis was localized at the same site of injection, while in the 3 other cases following vector vaccines ChAdOx1 nCoV-19, inflammatory myositis affected the proximal muscles of the lower limbs mainly.…”

Section: Discussionmentioning

confidence: 99%

Dermatomyositis Following BNT162b2 mRNA COVID-19 Vaccination

et al. 2022

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Dermatomyositis (DM) is one of the uncommon multi-organ idiopathic inflammatory myopathies that has been reported following the hepatitis B, Influenza, tetanus toxoid, H1N1, and BCG vaccines. However, an association with the coronavirus disease 2019 (COVID-19) vaccine is yet to be reported. In this case, we present the case of a 43-year-old Asian Indian female who was diagnosed with DM 10 days after receiving the second dosage of BNT162b2 mRNA COVID-19 vaccination, in the absence of any additional triggering factors. The diagnosis was established based on physical examination, serological antibodies, magnetic resonance imaging of the muscles, skin biopsy, and electromyography. She received standard treatment for DM, including oral high doses of prednisolone, hydroxychloroquine, mycophenolate, and physiotherapy. The treatment successfully reversed skin changes and muscle weakness. This is the first reported case of classic DM complicated by interstitial lung disease following COVID-19 vaccination. More clinical and functional studies are needed to elucidate this association. Clinicians should be aware of this unexpected adverse event following COVID-19 vaccination and arrange for appropriate management.

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Section: Discussionmentioning

confidence: 99%

Dermatomyositis Following BNT162b2 mRNA COVID-19 Vaccination

et al. 2022

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“…The most common rheumatic adverse events in healthy subjects, aside from arthralgias, are seronegative arthritis [17], polymyalgia rheumatica [17,18] and skin, urticarial or leukocytoclastic, vasculitis [19][20][21]. Specifically focusing on IIM, only scanty data are available: 5 papers, for a sum of 8 patients [22][23][24][25][26] mentioned the occurrence of myositis after vaccination and in all of them the course of disease was favorable, with an overall good response to treatment. Notably, in 3 of them a concomitant anti-SAE or anti-Pm/Scl 75 positivity was assessed.…”

Section: Discussionmentioning

confidence: 99%

Relapses of idiopathic inflammatory myopathies after vaccination against COVID-19: a real-life multicenter Italian study

et al. 2022

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccination plays a crucial role as pivotal strategy to curb the coronavirus disease-19 (COVID-19) pandemic. The present study described the clinical status of patients affected by idiopathic inflammatory myopathies (IIM) after COVID-19 vaccination to assess the number of relapses. We included all patients affected by IIM and followed by Myositis Clinic, Rheumatology and Respiratory Diseases Units, Siena University Hospital, Bari University Hospital, Policlinico Umberto I, Sapienza University, Rome, and Policlinico Paolo Giaccone, Palermo. They underwent a telephone survey. A total of 119 IIM patients (median, IQR 58 (47–66) years; 32males; 50 dermatomyositis, 39 polymyositis and 30 anti-synthetase syndrome) were consecutively enrolled. Except four patients who refused the vaccination, 94 (81.7%) received Comirnaty, 16 (13.9%) Spikevax, 5 (4.4%) Vaxzevria. Seven (6.1%) patients had flare after vaccination. One of them had life-threatening systemic involvement and died two months after second dose of COVID-19 vaccination. From logistic regression analysis, Chi2-log ratio = 0.045,the variable that most influences the development of flare was the number of organs involved (p = 0.047). Sixty-eight patients received the third dose of COVID-19 vaccination: 51(75%) Comirnaty and 17 (25%) Moderna. No patients had flares after third dose. Our study represents the largest cohort of IIM patients in which the incidence of recurrence after anti-SARS-CoV-2 vaccine was assessed. In line with real-life data from other diseases, we found a clinical non-statistically significant risk of relapse in our patients, which occurred seldom, usually mild and in patients with a more severe and aggressive course of disease.

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“…To the best of our knowledge, a few cases have been reported worldwide, and this was the first case in South Korea. 15 16 17 18 This suggests that inflammatory myositis after COVID-19 vaccination is temporally, clinically, and histologically heterogeneous. Herein, muscle biopsy enabled accurate diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Characteristics of Inflammatory Myositis Induced by COVID-19 Vaccine (Pfizer-BioNTech BNT162b2): A Case Report

Kim

Woo

2022

J Korean Med Sci

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As more individuals were coronavirus disease 2019 (COVID-19) vaccinated, unexpected side effects appeared. Herein, we present the case of a 30-year-old man with myopathy in both extremities after the second dose of the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine. Symptoms, swelling and pain, started from the proximal upper and lower extremities and extended to the distal parts. Although he underwent massive hydration, the muscle enzyme level continuously increased. He complained of dysphagia and dysarthria. Microscopically, muscle biopsy showed multifocal or scattered macrophage infiltration and degenerated myofibers. In contrast to general myopathy including inflammatory myositis and rhabdomyolysis, vaccine-induced inflammatory myositis shows a prolonged increase in muscle enzyme levels and multifocal macrophage infiltration with necrosis of the muscle fibers. Symptoms improved with glucocorticoid and immunosuppressive treatment. If vaccinated individuals experience severe and continuous muscle pain and swelling, clinicians should consider vaccine-induced inflammatory myositis, measure the muscle enzyme levels, and perform muscle biopsy for a definite diagnosis.

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COVID-19 vaccine-induced cellulitis and myositis

Cited by 23 publications

References 7 publications

Dermatomyositis Following BNT162b2 mRNA COVID-19 Vaccination

Dermatomyositis Following BNT162b2 mRNA COVID-19 Vaccination

Relapses of idiopathic inflammatory myopathies after vaccination against COVID-19: a real-life multicenter Italian study

Clinicopathological Characteristics of Inflammatory Myositis Induced by COVID-19 Vaccine (Pfizer-BioNTech BNT162b2): A Case Report

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