MPO-ANCA associated vasculitis with mononeuritis multiplex following influenza vaccination

Abstract

BackgroundAlthough influenza vaccines are generally safe and effective, a variety of autoimmune phenomena have been reported after vaccination over the past years, such as Guillain–Barre syndrome, rheumatoid arthritis, pemphigus vulgaris, psoriasis, giant cell arteritis and anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV).Case reportWe describe the case of a 67-year old man who presented with a myeloperoxidase-ANCA associated vasculitis with renal involvement and mononeuritis multiplex after seasonal influenza vaccination. He was initially treated with intravenous cyclophosphamide and high-dose prednisolone followed by maintenance treatment consisting of azathioprine and prednisolone.ConclusionWe hypothesize that seasonal influenza vaccination triggered a systemic immune response in a susceptible patient to develop AAV with renal involvement and vasculitic neuropathy. In general, seasonal influenza vaccinations are considered to be safe, however, clinicians should be aware of this rare phenomenon.

ANCA-Associated Vasculitis Following Pfizer-BioNTech COVID-19 Vaccine

“…Anti-Neutrophil Cytoplasmic Antibody (ANCA)- associated vasculitis (AAV) is a small vessel vasculitis hallmarked by the presence of antibodies against antigens in cytoplasmic granules of neutrophils. 6 While there are many case reports describing a temporal association between influenza vaccination and new onset/relapse of AAAV, 7 , 8 , 9 , 10 , 11 there are few reports of this occurring after receiving the COVID19 vaccine. 15 We report a case of new onset renal limited anti-myeloperoxidase (MPO)-AAV following COVID19 vaccination.…”

A Case of Antineutrophil Cytoplasmic Antibodies (ANCA)-Associated Vasculitis Post COVID-19 Vaccination

“…Studies have suggested that vaccines contain adjuvant molecules that may provoke autoimmune responses. Additionally, vaccine antigens could trigger an autoimmune response via molecular mimicry [14][15][16][17]. Arguably, vaccine-associated AAV is more widely studied with the influenza vaccines.…”

Autoimmune hepatitis following influenza virus vaccination

“…Previous reports have demonstrated that influenza vaccination may trigger or exacerbate symptoms of a few autoimmune diseases such as Guillain–Barre syndrome, multiple sclerosis, and myeloperoxidase antineutrophil cytoplasmic antibody-associated vasculitis. [ 16 – 18 ] Although a causal link cannot be definitively established between influenza virus vaccination and the development of AIH, because immunization might be a possible cause of other autoimmune diseases, it is reasonable to hypothesize that influenza virus vaccination could trigger the development of AIH.…”