S2431 Ulcerative Colitis Flare-Ups Following mRNA COVID-19 Vaccination

Wang, Yuyao; Hsieh, Tien‐Chan; Lee, Gin Yi; Gorelick, Steven M.; Maslak, David

doi:10.14309/01.ajg.0000783256.85441.e1

Cited by 4 publications

(4 citation statements)

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“…Flares of the primary disease after COVID-19 vaccination have been reported in autoimmune diseases, including systemic rheumatic diseases (13), systemic lupus erythematosus (14,15), and hematologic diseases, including idiopathic thrombocytopenic purpura (16), paroxysmal nocturnal hemoglobinuria (17), and IgA nephropathy (12,18). Similarly, disease flares after COVID-19 vaccination have been reported in IBD, although only infrequently (19)(20)(21). Several studies have reported the flare rate after COVID-19 vaccination has been shown.…”

Section: Discussionmentioning

confidence: 99%

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Disease Flares Following COVID-19 Vaccination in Patients with Inflammatory Bowel Disease

Yoshida,

Fujioka,

Moriyama

et al. 2023

Intern. Med.

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Objective Flares of inflammatory bowel disease (IBD) can occur infrequently after vaccination for coronavirus disease 2019 (COVID-19), although the details of this phenomenon are poorly understood. To clarify the possibility of an unfavorable response in patients with IBD, we investigated IBD-related symptoms during the COVID-19 vaccination. Methods Between October 2021 and February 2022, we obtained the COVID-19 vaccination status of 411 IBD patients who were being treated at our institution. The disease course of IBD after vaccination was investigated in 188 patients with ulcerative colitis (UC) and 119 patients with Crohn's disease (CD) who had received at least one dose of the vaccine during the clinical remission phase. The baseline characteristics before vaccination were compared between the patients with UC with or without disease flares. Results During the 30-day follow-up period, eight patients with UC (4.3%) and one patient with CD (0.8%) experienced disease flares following vaccination. Disease flares occurred after the first vaccination in six patients and after the second vaccination in three patients. As for the timing of onset of disease flares, eight events (88.9%) occurred within one week of vaccination. Two patients required hospitalization, and one patient with CD required surgery for an intra-abdominal abscess. The baseline characteristics did not significantly differ between patients with UC who experienced flares and those who did not. Conclusion IBD flares following COVID-19 vaccination are rare and vaccination should therefore be recommended for patients with IBD. However, the possibility of disease flares should be considered for approximately one week after each vaccination, especially in patients with UC.

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Section: Discussionmentioning

confidence: 99%

“…Coronavirus disease 2019 (COVID- 19) is a systemic infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and vaccination is recommended as an important strategy to control the pandemic (1). Vaccination is recommended for most people, with particular emphasis on immunocompromised patients (2).…”

Section: Introductionmentioning

confidence: 99%

Disease Flares Following COVID-19 Vaccination in Patients with Inflammatory Bowel Disease

Yoshida,

Fujioka,

Moriyama

et al. 2023

Intern. Med.

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“…His UC might be exacerbated by vaccine shot. So far, only one case with UC flare-ups following COVID-19 mRNA vaccination in the setting of long-term remission history was reported [ 22 ]. It has been reported that PR3-ANCAs are associated with UC in adults [ 23 ], and PR3-ANCA by chemiluminescence immunoassay was reported to be highly specific for distinguishing between UC and Crohn's disease [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

IgA vasculitis with transient glomerular hematuria, diarrhea, and pericarditis following COVID-19 mRNA vaccination in a young patient with possible pre-existing ulcerative colitis

et al. 2022

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Exacerbations or de novo autoimmune/autoinflammatory disease have been reported after COVID-19 vaccination. A young male presented with cutaneous IgA vasculitis with glomerular hematuria, diarrhea and pericarditis following his second COVID-19 mRNA vaccination. He also showed positivity for proteinase 3 anti-neutrophil cytoplasmic antibody (PR3-ANCA) and anti-cardiolipin antibody. Skin biopsy was compatible to IgA vasculitis. His purpura subsided and hematuria spontaneously disappeared. Treatment with anti-inflammatory medications and prednisolone resolved the pericarditis. He had a history of persistent diarrhea, and colonic biopsies showed possible ulcerative colitis without vasculitis. Kidney biopsy after prednisolone therapy revealed minor glomerular abnormalities without any immune reactants and did not show vasculitis. After prednisolone treatment, PR3-ANCA decreased in a medium degree despite of improvement of symptoms and inflammatory data, suggesting that his PR3-ANCA may be associated with ulcerative colitis. The cause of the transient glomerular hematuria was unclear, however, it might be caused by focal glomerular active lesions (glomerular vasculitis) due to vaccine-induced IgA vasculitis with nephritis. This case highlights that COVID-19 mRNA vaccination can activate multiple autoimmune/autoinflammatory systems. The conditions might help us better understand the mutual mechanisms of the relevant disorders.

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“…Post-vaccination gastrointestinal spontaneous issues have also appeared in current literature, and there exist reports for Ulcerative Colitis (UC) flares in two middle-aged women, with an abdominopelvic CT to demonstrate contiguous colitis, where one woman was discharged after mesalamine/methylprednisolone, whereas the other one was diagnosed with diffuse colitis followed by a colonoscopy abortion due to extensive colitis; finally, complications led to a total colectomy [ 97 ]. Another case of post-vaccination-occurring UC was also reported in a 36-year-old woman with a medical history of UC and autoimmune pancreatitis, and, finally, symptoms improved after steroids [ 98 ].…”

Section: Mrna Vaccination Against Covid-19 and Diagnosis Of Spontaneo...mentioning

confidence: 99%

Current Evidence in SARS-CoV-2 mRNA Vaccines and Post-Vaccination Adverse Reports: Knowns and Unknowns

Mouliou

Dardiotis

2022

Diagnostics

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The novel mRNA vaccinations against COVID-19 are gaining worldwide attention for their efficacy, as well as the diagnosis of some post-vaccination-reported adverse reactions. In this state-of-the-art review article, we present the current evidence regarding mainly the diagnosis of spontaneous allergic reactions, the skin occurrences, the vascular, blood, endocrine and heart events, the respiratory reports, the gastrointestinal, hepatic and kidney events, the reproductive and pregnancy issues and the muscle events, as well as the ear, eye, neurologic and psychiatric events following mRNA vaccination against COVID-19. We further present some evidence regarding the mRNA strategies and we discuss our expert opinion on the knowns and the unknowns towards the topic.

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S2431 Ulcerative Colitis Flare-Ups Following mRNA COVID-19 Vaccination

Cited by 4 publications

References 0 publications

Disease Flares Following COVID-19 Vaccination in Patients with Inflammatory Bowel Disease

Disease Flares Following COVID-19 Vaccination in Patients with Inflammatory Bowel Disease

IgA vasculitis with transient glomerular hematuria, diarrhea, and pericarditis following COVID-19 mRNA vaccination in a young patient with possible pre-existing ulcerative colitis

Current Evidence in SARS-CoV-2 mRNA Vaccines and Post-Vaccination Adverse Reports: Knowns and Unknowns

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