Possible case of polyarteritis nodosa with epididymitis following COVID-19 vaccination: A case report and review of the literature

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

doi:10.1093/mrcr/rxac085

Cited by 11 publications

(6 citation statements)

References 24 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%

“…Among the MVV patients, one had cutaneous polyarteritis nodosa (PAN) [54], and the remaining five had systemic PAN. Out of these, one patient presented with acute anterior uveitis, and magnetic resonance angiography (MRA) of the abdomen was suggestive of vasculitis involving the celiac trunk [49], and another patient had associated myalgia, and a muscle biopsy of the left gastrocnemius also showed fibrinoid necrosis [111]. Another patient had an acute kidney injury with a kidney biopsy that showed features of necrotising vasculitis and required cyclophosphamide and haemodialysis for 32 days [36].…”

Section: Medium-vessel Vasculitismentioning

confidence: 99%

“…Twenty-two patients (91.6%) had a positive myositis antigen profile (MAP). Of the two patients with no MAP, one had a positive ribonucleoprotein (RNP) antibody [111]. The most common antibody was anti-melanoma differentiation-associated gene 5 (anti-MDA-5), followed by Ro-52 and anti-TIF-1.…”

Section: Idiopathic Inflammatory Myositismentioning

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

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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: Medium-vessel Vasculitismentioning

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

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“…Ohkubo et al reported a 61-year-old man diagnosed with PAN and epididymitis following the BNT162b2 vaccine. The patient was treated with prednisolone and antibiotics [ 10 ]. Prior analysis of the Vaccine Adverse Event Reporting System (VAERS) has described 10 cases of possible PAN from the HBV vaccine [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Polyarteritis Nodosa Following mRNA-1273 COVID-19 Vaccination: Case Study and Review of Immunological Mechanisms

Srichawla¹

2023

Cureus

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Numerous post-vaccine complications have been reported secondary to the COVID-19 vaccine. Many of these complications are believed to be due to a hyperactive immune system. A 59-year-old woman developed diffuse abdominal pain two days after receiving the mRNA-1273 COVID-19 vaccine (Moderna). A computerized tomography (CT) angiogram of the abdomen and pelvis revealed the presence of numerous vascular irregularities in the celiac axis, bilateral renal arteries, and inferior mesenteric artery consistent with polyarteritis nodosa (PAN), a medium-vessel vasculitis. The patient was managed with intravenous methylprednisolone 500 mg daily for three days and was then placed on oral methotrexate (MTX) 12.5 mg daily for immunosuppressive maintenance treatment. Until now, a limited number of cases of polyarteritis nodosa secondary to the COVID-19 vaccine have been reported. Major mechanisms of post-vaccine autoimmunity are molecular mimicry and autoantibody production. Although rare adverse events from COVID-19 vaccination are possible, there remains an immense benefit to vaccination in preventing COVID-19-related morbidity and mortality.

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“…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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Possible case of polyarteritis nodosa with epididymitis following COVID-19 vaccination: A case report and review of the literature

Cited by 11 publications

References 24 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 Following mRNA-1273 COVID-19 Vaccination: Case Study and Review of Immunological Mechanisms

Polyarteritis Nodosa: Old Disease, New Etiologies

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