Recurring Weakness in Rhabdomyolysis Following Pfizer–BioNTech Coronavirus Disease 2019 mRNA Vaccination

Kimura, Motoya; Niwa, Jun-ichi; Doyu, Manabu

doi:10.3390/vaccines10060935

Cited by 8 publications

(6 citation statements)

References 24 publications

(37 reference statements)

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“…We include the vaccination against COVID-19, 22 although PAP-1 deficiency significantly suppresses SARS-CoV-2 replication 23 and this vaccine can be responsive for RM. 24 The innate immune system acts as the first line of defense against invading pathogens. Induction of an antiviral innate immune response depends on the TLRs, which then activate signaling pathways and induce the production of antiviral cytokines and chemokines.…”

Section: Discussionmentioning

confidence: 99%

“…We recommend vaccinating lipin‐1‐deficient patients with all available vaccines, as the risk of decompensation is very high during epidemics of viral disease, and corticosteroids can make chickenpox worse. We include the vaccination against COVID‐19, 22 although PAP‐1 deficiency significantly suppresses SARS‐CoV‐2 replication 23 and this vaccine can be responsive for RM 24 …”

Section: Discussionmentioning

confidence: 99%

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Systemic corticosteroids for the treatment of acute episodes of rhabdomyolysis in lipin‐1‐deficient patients

Tuchmann-Durand

Roda

Renard

et al. 2023

J of Inher Metab Disea

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Mutations in the LPIN1 gene constitute a major cause of severe rhabdomyolysis (RM). The TLR9 activation prompted us to treat patients with corticosteroids in acute conditions. In patients with LPIN1 mutations, RM and at‐risk situations that can trigger RM have been treated in a uniform manner. Since 2015, these patients have also received intravenous corticosteroids. We retrospectively compared data on hospital stays by corticosteroid‐treated patients vs. patients not treated with corticosteroids. Nineteen patients were hospitalized. The median number of admissions per patient was 21 overall and did not differ when comparing the 10 corticosteroid‐treated patients with the 9 patients not treated with corticosteroids. Four patients in the non‐corticosteroid group died during a RM (mean age at death: 5.6 years). There were no deaths in the corticosteroid group. The two groups did not differ significantly in the number of RM episodes. However, for the six patients who had RM and occasionally been treated with corticosteroids, the median number of RM episodes was significantly lower when intravenous steroids had been administered. The peak plasma creatine kinase level and the area under the curve were or tended to be higher in patients treated with corticosteroids—even after the exclusion of deceased patients or focusing on the period after 2015. The median length of stay (10 days overall) was significantly longer for corticosteroid‐treated patients but was similar after the exclusion of deceased patients. The absence of deaths and the higher severity of RM observed among corticosteroid‐treated patients could suggest that corticotherapy is associated with greater survival.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Systemic corticosteroids for the treatment of acute episodes of rhabdomyolysis in lipin‐1‐deficient patients

Tuchmann-Durand

Roda

Renard

et al. 2023

J of Inher Metab Disea

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“…Although BNT162b2 COVID-19 vaccination is safe and most of the adverse effects are mild [ 54 ], some moderate to serious adverse events such as anaphylaxis [ 24 , 25 , 26 , 27 ], thrombocytopenia [ 28 , 29 , 30 , 31 ], myocarditis [ 32 , 33 , 34 , 35 , 36 ], myositis [ 37 , 38 , 39 , 40 , 41 ] and rhabdomyolysis [ 42 , 43 , 44 ] were recently reported. Therefore, it is crucial to identify the factors associated with adverse effects after BNT162b2 vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, several mild to moderate rare cases of anaphylaxis [ 24 , 25 , 26 , 27 ], thrombocytopenia [ 28 , 29 , 30 , 31 ], myocarditis [ 32 , 33 , 34 , 35 , 36 ], myositis [ 37 , 38 , 39 , 40 , 41 ], and rhabdomyolysis [ 42 , 43 , 44 ] associated with the BNT162b2 vaccine have been reported. Here, we report a rare case of BNT162b2 vaccine-associated myositis in which the patient was severely affected.…”

Section: Introductionmentioning

confidence: 99%

Clinical and Molecular Characterization of a Rare Case of BNT162b2 mRNA COVID-19 Vaccine-Associated Myositis

et al. 2022

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Initial clinical trials and surveillance data have shown that the most commonly administered BNT162b2 COVID-19 mRNA vaccine is effective and safe. However, several cases of mRNA vaccine-induced mild to moderate adverse events were recently reported. Here, we report a rare case of myositis after injection of the first dose of BNT162b2 COVID-19 mRNA vaccine into the left deltoid muscle of a 34-year-old, previously healthy woman who presented progressive proximal muscle weakness, progressive dysphagia, and dyspnea with respiratory failure. One month after vaccination, BNT162b2 vaccine mRNA expression was detected in a tissue biopsy of the right deltoid and quadriceps muscles. We propose this case as a rare example of COVID-19 mRNA vaccine-induced myositis. This study comprehensively characterizes the clinical and molecular features of BNT162b2 mRNA vaccine-associated myositis in which the patient was severely affected.

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“…Cases of fatal myositis with rhabdomyolysis and acute kidney injury necessitating renal replacement therapy have been reported post-COVID vaccination [ 102 •, 103 ]. Kimura and colleagues described a patient who developed recurrent, relapsing muscle weakness after the Pfizer vaccine with MRI demonstrating myoedema.…”

Section: Covid-19 Vaccination and Pre-existing Or New-onset Cns Demye...mentioning

confidence: 99%

Neurological Complications Following COVID-19 Vaccination

Chatterjee

Chakravarty

2022

Curr Neurol Neurosci Rep

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Purpose of Review A variety of neurological complications have been reported following the widespread use of the COVID-19 vaccines which may lead to vaccine hesitancy and serve as a major barrier to the public health aim of achieving protective herd immunity by vaccination. In this article, we review the available evidence regarding these neurological adverse events reported, to provide clarity regarding the same so that unfounded fears maybe put to rest. Recent Findings There is a greater than expected occurrence of severe neurological adverse events such as cortical sinus venous thrombosis, Bell’s palsy, transverse myelitis, and Guillain–Barré syndromes along with other common effects such as headaches following different kinds of COVID-19 vaccination. Precipitation of new onset demyelinating brain lesions with or without detection of specific antibodies and worsening of pre-existing neurological disorders (like epilepsy, multiple sclerosis) are also a matter of great concern though no conclusive evidence implicating the vaccines is available as of now. Summary The COVID-19 pandemic is far from being over. Till such time that a truly effective anti-viral drug is discovered, or an appropriate therapeutic strategy is developed, COVID-appropriate behavior and highly effective mass vaccination remain the only weapons in our armamentarium to fight this deadly disease. As often occurs with most therapeutic means for the treatment and prevention of any disease, vaccination against COVID-19 has its hazards. These range from the most trivial ones like fever, local pain and myalgias to several potentially serious cardiac and neurological complications. The latter group includes conditions like cerebral venous thrombosis (curiously often with thrombocytopenia), transverse myelitis and acute inflammatory demyelinating polyneuropathy amongst others. Fortunately, the number of reported patients with any of these serious complications is far too low for the total number of people vaccinated. Hence, the current evidence suggests that the benefits of vaccination far outweigh the risk of these events in majority of the patients. As of now, available evidence also does not recommend withholding vaccination in patients with pre-existing neurological disorders like epilepsy and MS, though adenoviral vaccines should be avoided in those with history of thrombotic events.

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Recurring Weakness in Rhabdomyolysis Following Pfizer–BioNTech Coronavirus Disease 2019 mRNA Vaccination

Cited by 8 publications

References 24 publications

Systemic corticosteroids for the treatment of acute episodes of rhabdomyolysis in lipin‐1‐deficient patients

Systemic corticosteroids for the treatment of acute episodes of rhabdomyolysis in lipin‐1‐deficient patients

Clinical and Molecular Characterization of a Rare Case of BNT162b2 mRNA COVID-19 Vaccine-Associated Myositis

Neurological Complications Following COVID-19 Vaccination

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