Medium-vessel Vasculitis Presenting with Myalgia Following COVID-19 Moderna Vaccination

Ohmura, Shin-Ichiro; Ohkubo, Yuji; Ishihara, Ryuhei; Otsuki, Yoshiro; Miyamoto, Toshiaki

doi:10.2169/internalmedicine.0293-22

Cited by 6 publications

(6 citation statements)

References 29 publications

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“…A total of six patients belonged to medium vessel vasculitis (MVV) [36,49,54,104,111,141]. Among the MVV patients, one had cutaneous polyarteritis nodosa (PAN) [54], and the remaining five had systemic PAN.…”

Section: Medium-vessel Vasculitismentioning

confidence: 99%

“…Of six patients with subacute cutaneous lupus (SACL), three developed widespread skin rashes on the trunk and limbs [117,141,142]. The remaining patients had localised cutaneous rashes, mainly on the face.…”

Section: Subacute Cutaneous Lupusmentioning

confidence: 99%

“…The remaining patients had localised cutaneous rashes, mainly on the face. Anti-Ro antibodies were positive in all six patients, and SACL was confirmed on skin biopsy [117,125,[140][141][142][143]. A skin biopsy revealed hyperkeratosis in the epidermis and the dermal infiltration of lymphocytic and histiocytes.…”

Section: Subacute Cutaneous Lupusmentioning

confidence: 99%

See 2 more Smart Citations

New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

Nune,

Durkowski,

Pillay

et al. 2023

Vaccines

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A comprehensive, up-to-date systematic review (SR) of the new-onset rheumatic immune-mediated inflammatory diseases (R-IMIDs) following COVID-19 vaccinations is lacking. Therefore, we investigated the demographics, management, and prognosis of new R-IMIDs in adults following SARS-CoV-2 vaccinations. A systematic literature search of Medline, Embase, Google Scholar, LitCovid, and Cochrane was conducted. We included any English-language study that reported new-onset R-IMID in adults following the post-COVID-19 vaccination. A total of 271 cases were reported from 39 countries between January 2021 and May 2023. The mean age of patients was 56 (range 18–90), and most were females (170, 62.5%). Most (153, 56.5%) received the Pfizer BioNTech COVID-19 vaccine. Nearly 50% of patients developed R-IMID after the second dose of the vaccine. Vasculitis was the most prevalent clinical presentation (86, 31.7%), followed by connective tissue disease (66, 24.3%). The mean duration between the vaccine’s ‘trigger’ dose and R-IMID was 11 days. Most (220, 81.2%) received corticosteroids; however, 42% (115) received DMARDs such as methotrexate, cyclophosphamide, tocilizumab, anakinra, IV immunoglobulins, plasma exchange, or rituximab. Complete remission was achieved in 75 patients (27.7%), and 137 (50.6%) improved following the treatment. Two patients died due to myositis. This SR highlights that SARS-CoV-2 vaccines may trigger R-IMID; however, further epidemiology studies are required.

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Section: Medium-vessel Vasculitismentioning

confidence: 99%

Section: Subacute Cutaneous Lupusmentioning

confidence: 99%

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New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

Nune,

Durkowski,

Pillay

et al. 2023

Vaccines

View full text Add to dashboard Cite

show abstract

“…More recently, vasculitis has been associated with COVID-19 infection, but to date no cases of PAN have been reported [36,37]. COVID-19 vaccines have been associated with PAN manifestations [38][39][40]. Like other vasculitides, PAN can be induced by the use of certain drugs, such as minocycline [41].…”

Section: Physiopathologymentioning

confidence: 99%

Polyarteritis Nodosa: Old Disease, New Etiologies

Wolff,

Horisberger,

Moi

et al. 2023

IJMS

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Polyarteritis nodosa (PAN), also known as panarteritis nodosa, represents a form of necrotizing vasculitis that predominantly affects medium-sized vessels, although it is not restricted to them and can also involve smaller vessels. The clinical presentation is heterogeneous and characterized by a significant number of patients exhibiting general symptoms, including asthenia, fever, and unintended weight loss. Although PAN can involve virtually any organ, it preferentially affects the skin, nervous system, and the gastrointestinal tract. Orchitis is a rare but specific manifestation of PAN. The absence of granulomas, glomerulonephritis, and anti-neutrophil cytoplasmic antibodies serves to distinguish PAN from other types of vasculitis. Major complications consist of hemorrhagic and thrombotic events occurring in mesenteric, cardiac, cerebral, and renal systems. Historically, PAN was frequently linked to hepatitis B virus (HBV) infection, but this association has dramatically changed in recent years due to declining HBV prevalence. Current epidemiological research often identifies a connection between PAN and genetic syndromes as well as neoplasia. This article provides a comprehensive review of PAN, specifically focusing on the progression of its clinical manifestations over time.

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“…Multiple vaccines were approved, which include the mRNA vaccines (Pfizer-BioNTech or mRNA-Moderna), viral vector vaccines (Johnson & Johnson or Oxford) and inactivated viral vaccines. Although these vaccines have been effective and safe in most conditions, different drug reactions were reported, such as vasculitis [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

Polyarteritis nodosa in a patient with chronic hepatitis B following COVID-19 vaccination: a case report

Abuhammad,

Dukmak,

Asad

et al. 2023

Oxford Medical Case Reports

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Different types of vasculitis have been reported after various vaccine administrations. Recently, the coronavirus disease 2019 (COVID-19) vaccine was one of the most common vaccine-induced vasculitis. Herein, we describe a 56-year-old male patient with chronic hepatitis B who presented with abdominal pain for 2 days, which was associated with vomiting and bloody diarrhea. He had a history of petechial rash for 25 days, multiple joint pain and lower limb weakness after the second dose of the COVID-19 vaccine. A skin biopsy showed medium-sized vessel vasculitis. Polyarteritis nodosa (PAN) was diagnosed depending on the American College of Rheumatology criteria. He was treated with steroids, plasmapheresis and antiviral medication with a good prognosis. In patients with a past medical history of chronic hepatitis B, the covid vaccine may be associated with an increased risk of developing a PAN, so clinicians should suspect the occurrence of this disease after COVID-19 vaccination.

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Medium-vessel Vasculitis Presenting with Myalgia Following COVID-19 Moderna Vaccination

Cited by 6 publications

References 29 publications

New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

Polyarteritis Nodosa: Old Disease, New Etiologies

Polyarteritis nodosa in a patient with chronic hepatitis B following COVID-19 vaccination: a case report

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