The need to shed light on potential insidious SARS-CoV-2 post-vaccination pituitary lesions

Ach, Taïeb; Euch, M. El

doi:10.1016/j.therap.2022.11.012

Cited by 5 publications

(11 citation statements)

References 4 publications

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“…SC2V-related cerebrovascular diseases include VST, ischemic stroke, ICH, SAB, pituitary apoplexy, RCVS, cerebral vasculitis, and Susac syndrome ( Table 2 ) [ 4 , 6 …”

Section: Resultsmentioning

confidence: 99%

“…Serial MRIs revealed pituitary apoplexy that partially resolved after three months [ 41 ]. Pituitary apoplexy was also reported in a 50-year-old male who developed nausea, vomiting, diplopia, and headache 1 day after the third MOV dose [ 42 ]. The patient profited from trans-sphenoidal resection [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Pituitary apoplexy was also reported in a 50-year-old male who developed nausea, vomiting, diplopia, and headache 1 day after the third MOV dose [ 42 ]. The patient profited from trans-sphenoidal resection [ 42 ]. Immune-histochemical evidence for SARS-CoV-2 proteins next to pituitary capillaries was provided [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…The patient profited from trans-sphenoidal resection [ 42 ]. Immune-histochemical evidence for SARS-CoV-2 proteins next to pituitary capillaries was provided [ 42 ]. Bleeding was explained by endothelialitis of pituitary capillaries, cross-reactivity of SARS- CoV-2 with pituitary proteins, by coagulopathy due to PF-4 antibodies, or acutely increased blood demand [ 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…Immune-histochemical evidence for SARS-CoV-2 proteins next to pituitary capillaries was provided [ 42 ]. Bleeding was explained by endothelialitis of pituitary capillaries, cross-reactivity of SARS- CoV-2 with pituitary proteins, by coagulopathy due to PF-4 antibodies, or acutely increased blood demand [ 42 ]. Pituitary apoplexy 1 day after the second AZV dose was also reported in a 24-year-old female, who manifested with new, sudden-onset frontal headache that benefited from hormone substitution for pituitary insufficiency [ 43 ].…”

Section: Resultsmentioning

confidence: 99%

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Neurological Adverse Reactions to SARS-CoV-2 Vaccines

Finsterer¹

2023

Clin Psychopharmacol Neurosci

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SARS-CoV-2 vaccines are not free of side effects and most commonly affect the central or peripheral nervous system (CNS, PNS). This narrative review aims to summarise recent advances in the nature, frequency, management, and outcome of neurological side effects from SARS-CoV-2 vaccines. CNS disorders triggered by SARS-CoV-2 vaccines include headache, cerebro-vascular disorders (venous sinus thrombosis [VST], ischemic stroke, intracerebral hemorrhage, subarachnoid bleeding, reversible, cerebral vasoconstriction syndrome, vasculitis, pituitary apoplexy, Susac syndrome), inflammatory diseases (encephalitis, meningitis, demyelinating disorders, transverse myelitis), epilepsy, and a number of other rarely reported CNS conditions. PNS disorders related to SARS-CoV-2 vaccines include neuropathy of cranial nerves, mono-/polyradiculitis (Guillain-Barre syndrome [GBS]), Parsonage-Turner syndrome (plexitis), small fiber neuropathy, myasthenia, myositis/dermatomyositis, rhabdomyolysis, and a number of other conditions. The most common neurological side effects are facial palsy, intracerebral hemorrhage, VST, and GBS. The underlying pathophysiology is poorly understood, but several speculations have been generated to explain the development of CNS/PNS disease after SARS-CoV-2 vaccination. In conclusion, neurological side effects develop with any type of SARS-CoV-2 vaccine and are diverse, can be serious and even fatal, and should be taken seriously to initiate early treatment and improve outcome and avoid fatalities. KEY WORDS: Side effects; COVID-19 vaccination; Neurological; Brain; Nerves."venous sinus thrombosis", "multiple sclerosis", "acute disseminated encephalomyelitis", "seizure", "Guillain Barre syndrome", "Parsonage Turner syndrome", "myositis", and "myasthenia". In addition, reference lists were searched for additional articles that matched the search criteria. Neurological COVID Vaccination Complications 223Table 1. Most common marketed anti-SARS-CoV-2 vaccines Company Generic name Brand name Ⓡ Technology Number of dosages Biontech Pfizer BNT162b2 Comirnaty m-RNA Two/booster Moderna m-RNA1273 Spikevax m-RNA Two/booster Astra Zeneca ChAdOx1-S nCoV-19 Vaxzevira Viral vector Two/booster Curevac CVnCoV Zorecimeran m-RNA Two Novavax NVX-Cov2373 Novaxovid Protein subunit Two Johnson & Johnson Ad26.COV.2S Jcovden Viral vector One Sinovac CoronaVac CoronaVac Viral vector Two/booster Valneva VLA2001 COVID-19 vaccine Viral vector Two/booster Sinopharm COVID 2019 vaccine BIBP Viral vector Two/booster Gam-Covid-Vac Sputnik-V Gam-Covid-Vac Viral vector Two Bharat Biotech BBV152 Covaxin Viral vector Two/booster CanSino Biologics Ad5-nCoV Convidecia Viral vector Single Sinopharm BBIBP32-CorV Covilo Viral vector Two booster Sanofi Pasteur VidPrevtyn beta VidPrevtyn beta Protein subunit OneOriginal articles and reviews published between 1966 and December 2022 were included. Abstracts, proceedings, and editorials were excluded from data analysis. The review does not claim to be complete, since the number of words and references was...

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“…SC2V-related cerebrovascular diseases include VST, ischemic stroke, ICH, SAB, pituitary apoplexy, RCVS, cerebral vasculitis, and Susac syndrome ( Table 2 ) [ 4 , 6 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Neurological Adverse Reactions to SARS-CoV-2 Vaccines

Finsterer¹

2023

Clin Psychopharmacol Neurosci

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The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review

Taieb,

Nassim,

Asma

et al. 2024

ARM

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Long COVID-19, also known as post-acute sequelae of SARS-CoV-2 infection, is a condition where individuals who have recovered from the acute phase of COVID-19 continue to experience a range of symptoms for weeks or even months afterward. While it was initially thought to primarily affect the respiratory system, it has become clear that Long COVID-19 can involve various organs and systems, including the endocrine system, which includes the pituitary gland. In the context of Long COVID-19, there is a growing understanding of the potential implications for the pituitary gland. The virus can directly affect the pituitary gland, leading to abnormalities in hormone production and regulation. This can result in symptoms such as fatigue, changes in appetite, and mood disturbances. Long COVID-19, the persistent and often debilitating condition following acute COVID-19 infection, may be explained by deficiencies in ACTH and Growth hormone production from the pituitary gland. Corticotropin insufficiency can result in the dysregulation of the body’s stress response and can lead to prolonged feelings of stress, fatigue, and mood disturbances in Long COVID-19 patients. Simultaneously, somatotropin insufficiency can affect growth, muscle function, and energy metabolism, potentially causing symptoms such as muscle weakness, exercise intolerance, and changes in body composition. Recently, some authors have suggested the involvement of the pituitary gland in Post COVID-19 Syndrome. The exact mechanisms of viral action on infected cells remain under discussion, but inflammatory and autoimmune mechanisms are primarily implicated. The aim of our study will be to review the main pituitary complications following COVID-19 infection. Moreover, we will explain the possible involvement of the pituitary gland in the persistence of Post COVID-19 Syndrome.

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Unveiling the Etiopathogenic Spectrum of Hypophysitis: A Narrative Review

Menotti,

Giampietro,

Raia

et al. 2023

JPM

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Hypophysitis, a rare inflammatory disorder of the pituitary gland, has seen an uptick in reported cases in recent years. Our objective is to summarize the most recent research on the etiopathogenesis, molecular mechanisms, and genetics of both primary and secondary hypophysitis. Primary autoimmune hypophysitis (PAH): During the acute phase of the disease, the pituitary gland in enlarged due to the infiltration of T and B lymphocytes. The chronic phase is characterized by progressive and irreversible pituitary atrophy. APA may play a role in the management, diagnosis, and prognosis of PAH. Specific autoantibodies such as anti-GH, anti-PIT-1, and anti-T-PIT have been found in patients with hypophysitis and hypopituitarism. A recent study suggested that a mechanism of escaping clonal deletion and mounting an immune response against self antigens can explain the unusual nature of the immune response observed in PAH patients. A cytokine array shows the presence of gamma-interferon and interleukin-17. Patients carrying mutations in the PIT1 or PROP1 genes may present PAH. Individuals carrying the HLA DQ8 haplotype are four times more likely to develop PAH. Immune checkpoint inhibitors induce hypophysitis (IIHs): IIHs is an increasingly frequent toxicity of in patients on treatment with inhibitors targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed cell death-1 (PD-1). ICIs inhibit the CTLA-4 pathway, leading to overactivation of T lymphocytes. The binding of PD-1/PD-L1 suppresses the activity of T cells, promotes the conversion of T-helpers into T-regulatory cells, and activates pro-survival signaling pathways in cancer cells. Cytokines play a crucial role in IIHs. B-cell infiltration has been observed in IIHs, suggesting that antibody-mediated pituitary injury may contribute. Genetic polymorphisms of CTLA-4 and PD-1 genes can increase the risk of IIHs. HLA alleles may also be involved in the onset of IIHs; this HLA association presents a possible alternative mechanistic hypothesis. IIHs may also be linked to a paraneoplastic syndrome triggered by ectopic expression of pituitary specific antigens. SARS-CoV-2-related hypophysitis: Recently, the literature has reported occurrences of hypophysitis associated with the SARS-CoV-2 virus; long COVID-19 may also present as infundibulo-neuro-hypophysitis. The virus enters the central nervous system because of its distinct interaction with angiotensin-converting enzyme receptors via spike proteins binding the capillary endothelium, and it directly damages the pituitary cells. The effect of SARS-CoV-2 can occur indirectly through inflammation and the release of cytokines. The exact mechanism remains ambiguous. The available data on endocrine complications associated with the SARS-CoV-2 vaccine are scant. Nonetheless, isolated cases of hypophysitis have been documented. Treatment of hypophysitis: Glucocorticoids are the cornerstone in managing primary hypophysitis, given their targeted action on inflammation. A better understanding of the etiopathogenesis and molecular mechanism of hypophysitis can lead to more effective and personalized treatment strategies.

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The need to shed light on potential insidious SARS-CoV-2 post-vaccination pituitary lesions

Cited by 5 publications

References 4 publications

Neurological Adverse Reactions to SARS-CoV-2 Vaccines

Neurological Adverse Reactions to SARS-CoV-2 Vaccines

The Growing Understanding of the Pituitary Implication in the Pathogenesis of Long COVID-19 Syndrome: A Narrative Review

Unveiling the Etiopathogenic Spectrum of Hypophysitis: A Narrative Review

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