New-onset giant cell arteritis following COVID-19 mRNA (BioNTech/Pfizer) vaccine: a double-edged sword?

Alfaro, A. M. Anzola; Trives, Laura; Martínez-Barrio, Julia; Pinilla, Blanca; Álvaro‐Gracia, José María; Collada, J. Molina

doi:10.1007/s10067-021-06041-7

Cited by 18 publications

(22 citation statements)

References 10 publications

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“…This has indeed been observed by numerous studies around the world hence necessitating vaccination of such patients against COVID-19 in an effort to lessen the impact of infection and improve outcomes. Recent literature, however, has painted a picture of the COVID-19 vaccine as being a ‘double-edged sword’ in the case of patients with autoimmune diseases in that although it offers immunity against the disease, it may, in some cases, aggravate the otherwise stable condition [ 10 ]. Exacerbation of autoimmune conditions by a vaccine was only thought to be possible theoretically, however, with the description of this case and that by Tagliaferri et al, 2021, further investigation on the subject is warranted [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

An Interesting Case of Fatal Myasthenic Crisis Probably Induced by the COVID-19 Vaccine

Sonigra¹,

Sarna²,

Vaghela³

et al. 2022

Cureus

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A myasthenic crisis is a severe, life-threatening exacerbation of myasthenia gravis that causes a rapid onset of muscle weakness and fatigue that may result in tetraparesis, dyspnea, respiratory insufficiency, aspiration, and death. Bulbar muscle functions are markedly affected resulting in depressed cough reflex, swallowing, and speech. Thus, mechanical ventilation, supportive feeding, and critical care are essential for the survival of patients in a myasthenic crisis. Numerous precipitating factors of this condition are well known and include infections, various medications, pregnancy, and childbirth. Patients with myasthenia gravis are at a considerably higher risk of developing a debilitating coronavirus disease 2019 (COVID-19) infection due to the associated immunosuppression resulting from long-term corticosteroid use, which makes vaccination of such individuals necessary. However, the relationship between an exacerbation of myasthenia gravis and the COVID-19 vaccination is currently unknown. In this paper, we report the case of a 55-year-old male patient who developed a myasthenic crisis after receiving the first dose of the ChAdOx1-S (recombinant) vaccine (AstraZeneca batch number 210157; AstraZeneca plc, Cambridge, United Kingdom). Despite the administration of aggressive and intensive treatment over a period of 29-day hospitalization, the myasthenic crisis could not be reversed and the patient ultimately deteriorated and succumbed from multiple myocardial infarction events and organ failures. While it is still uncommon, evidence associating the effects of the vaccine to the development of a crisis is mounting; therefore, it is crucial for clinicians to promptly identify clinical features that suggest an exacerbation of myasthenia gravis in order to intervene at the earliest possible stage for a more favorable outcome. The myasthenia gravis patient should be informed about the possible association between COVID-19 vaccination and the development of a myasthenic crisis.

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Section: Discussionmentioning

confidence: 99%

An Interesting Case of Fatal Myasthenic Crisis Probably Induced by the COVID-19 Vaccine

Sonigra¹,

Sarna²,

Vaghela³

et al. 2022

Cureus

View full text Add to dashboard Cite

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“…After seven weeks of illness, she was diagnosed with GCA on a positron emission tomography (PET) scan with a CRP of 98 mg/L [ 10 ]. Other mRNA vaccine-related case reports include a 79-year-old man who developed GCA two days after his second dose of the vaccine [ 11 ], an 82-year-old man who developed bilateral GCA with skin necrosis 10 days after his second dose of vaccine [ 12 ], a new-onset GCA in an 83-year-old woman happened 24 hours after the first dose of the vaccine [ 13 ], a 63-year-old woman who developed GCA the day after the first dose of the vaccine [ 14 ], and a 78-year-old female diagnosed with large vessel vasculitis post vaccine with symptoms that started after the first shot and worsened after the second shot [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Giant Cell Arteritis With a Normal Erythrocyte Sedimentation Rate (ESR) Post ChAdOx1 nCoV-19 Vaccination

Xia¹,

Edwards²,

Omidvar³

2022

Cureus

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“…However, several investigators have reported large-vessel vasculitis following COVID-19 vaccination (22)(23)(24)(25)(26)(27). COVID-19 vaccines were associated with an increasing risk of GCA (reported reaction 2.7, 95% confidence interval: 2.3, 3.2) (27).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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Coronavirus disease 2019 (COVID-19) vaccines have been delivered worldwide to prevent the spread of the disease, and almost all Japanese have received the mRNA vaccines "BNT162b2" (Pfizer-Biotech) or "mRNA-1273" (Moderna). These vaccines have shown efficacy and safety with only minor adverse drug reactions. However, some patients develop severe adverse drug reactions, including autoimmune reactions. In addition, systemic vasculitis, mainly small-vessel vasculitis, following COVID-19 vaccination, has been reported. However, only a few investigators have reported medium-vessel vasculitis following vaccination. We herein report a case of medium-vessel vasculitis presenting with myalgia as the initial clinical manifestation following COVID-19 Moderna vaccination.

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New-onset giant cell arteritis following COVID-19 mRNA (BioNTech/Pfizer) vaccine: a double-edged sword?

Cited by 18 publications

References 10 publications

An Interesting Case of Fatal Myasthenic Crisis Probably Induced by the COVID-19 Vaccine

An Interesting Case of Fatal Myasthenic Crisis Probably Induced by the COVID-19 Vaccine

A Case of Giant Cell Arteritis With a Normal Erythrocyte Sedimentation Rate (ESR) Post ChAdOx1 nCoV-19 Vaccination

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

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