Medical Case Reports

  A 64-year-old man with active rheumatoid arthritis (RA) developed painful skin eruptions in both legs and hands 13 days after the first dose of mRNA COVID-19 vaccination, BNT162b2. The lesions were exacerbated after the second dose of BNT162b2 vaccination, although h e did not have a fever or any systemic symptoms. Laboratory examination revealed no remarkable change in blood counts, liver, or renal function except for mild increase of d-dimer suggesting abnormal coagulation.  Biopsy from the necrotic nodule in the left popliteal fossa revealed necrotic epidermis and underlying  occlusive vasculopathy in the middle to deep dermis with inflammatory infiltrates with neutrophils, leukocytoclasia, fibrin exudation, extravasated erythrocytes, and microthrombi (see panels B and C in the  Figure ). Also, there were lymphocytic infiltrates into the subcutaneous fat tissue (panel D ). Histological diagnosis of necrotizing vasculitis was made. In 88 day of the disease onset, some of the ves

COVID-19 vaccine-related pneumonitis (CV-P) should be considered in  patients with atypical lung infiltration, no specific etiologies, and recent  COVID-19  vaccination.  An article posted ahead of print by the Korean Journal of Internal Medicine describes 11 cases with a median age of 80. 10 individuals survived, but one patient with acute respiratory distress syndrome (ARDS), an 82-year-old-female, died despite appropriate treatment. Her chest CT displayed diffuse alveolar damage (DAD pattern).  Here are several other cases: An 83-year-old woman who received the second dose of BNT162b2-mRNA vaccine presented with an organizing pneumonia pattern of CV-P. Chest CT revealed multifocal patchy consolidations, ground-glass opacifications (GGOs), and mild interlobar septal thickening in both lungs (14 days after the second dose). BAL fluid analysis revealed neutrophils (Np) 24%, lymphocytes (Lp) 32%, eosinophils (Eo) 32%, and macrophages (Mq) 12%. All microbiological tests in BAL specimens

25 cases (16 men/9 women) presenting a relapse within one month of a  COVID-19  vaccine injection are reported in the new issue of Clinical Kidney Journal . It was of childhood onset in half the patients, but a ll patients were in a stable condition at the time of injection and 11 had no specific treatment. In 5 patients, the last relapse was reported more than five years before vaccine injection.  The Pfizer-bioNTech vaccine was used in 80% of the patients.  Oxford/AstraZeneca and Moderna vaccines caused relapse in the remaining 20% (3 and 2 cases, respectively).    Idiopathic Nephrotic Syndrome (INS) is a  rare primary glomerular group of diseases characterized by the triad of edema, massive, or nephrotic-range, proteinuria and hypoalbuminemia, for which there is no known cause. In 18 cases, the relapse of NS occurred after the first injection, a mean of 17.5 days after vaccination (range: 7–28 days). No clinical and/or laboratory findings of relapse were reported in the first week a

A previously healthy 28-year-old woman received the primary dose of adenovirus type 26 (Ad26) viral vector-based COVID-19 vaccine 35 (Janssen Pharmaceuticals,  Johnson & Johnson vaccine ). A few days later, she developed a swelling at the injection site. Over the next three months, the nodule progressively enlarged to become a plaque  with associated pain, warmth, and tingling sensation. She also developed cervical and left axillary lymphadenopathy, intermittent fevers, fatigue, and unintentional weight loss. Presumptive treatment for cellulitis with several courses of oral antibiotics was ineffective. According to the WHO-EORTC classification, the clinical and histopathologic findings were consistent with SPTCL -  Subcutaneous panniculitis-like T-cell lymphoma,  a rare type of lymphoma that mainly affects the skin . Lymphomas are cancers that result from a type of white blood cell that grows out of control.  T-cell lymphoma  begins in white blood cells called T cells (T lymphocy

A n Asian man in his 70s  developed a fever at home 11 days after his second dose of the mRNA vaccine BNT162b2 (disease day 0).  On disease day 10, he was admitted to the hospital f ollowing to his worsened status. On arrival, his oxygen saturation was 56% while he was breathing ambient air. R emdesivir, methylprednisolone treatment was initiated along with a single dose of 8 mg/kg tocilizumab . He required a noninvasive, positive-pressure ventilator for hypoxemia. On disease day 19, his oxygen level abruptly dropped, and  intubation  was needed. On disease day 26, soon after extubation, he developed  pneumothorax and  acute respiratory distress syndrome. H igh SARS-CoV-2 viral load (Delta variant, although s everal mix alleles were found in the specimens collected on disease days 27-29 ) was observed until 1 month after onset.  He died on disease day 31.  One year before admission he successfully  received six courses of bendamustine-rituximab (BR) therapy for stage 3 mucosa-associate

Kidney function can be impaired when there are problems with the glomeruli, the tiny units within the kidney where blood is cleaned.   There have been a small but increasing number of cases of new-onset and relapse of glomerular diseases reported to have occurred in temporal association with the COVID-19 vaccines. A new paper reports four such cases. A 23-year-old woman with no significant past medical history presented with 5 days of generalized swelling and frothy urine 7 days after receiving her 2 nd  dose of the Moderna vaccine. She exhibited 3+ bilateral leg edema, mild periorbital edema, an elevated blood pressure of 150/80 mmHg, and a urine dipstick showing 4+ protein. Based on laboratory findings, t he patient was diagnosed with  Minimal change disease ( MCD). The patient was started on a 1 mg/kg (70 mg) dose of oral prednisone together with a low dose of furosemide to help control her edema. Complete remission was achieved 4 weeks later.  A 74-year-old Japanese man had a medic

Vogt-Koyanagi-Harada (VKH) syndrome is an autoimmune, multi-systemic disease which can occur due to viral infection or vaccination. It affects many body systems, including as the eyes, ears, skin, and the covering of the brain and spinal cord (the meninges). The most noticeable symptom is a rapid loss of vision. A 62-year-old healthy female patient developed a severe headache and tinnitus 2 days after receiving COVID-19 immunization with the Oxford-AstraZeneca Chimpanzee Adenovirus Vectored Vaccine ChAdOx1 nCoV-19 (AZD1222). Two days later she developed an acute loss of vision in both eyes.  Fundus examination showed a serous retinal detachment and optic disc hyperemia OU  (see Figure).  Four more cases that had a likely association between VKH disease and  severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)  vaccination were reported this week in " Ocular Immunology and Inflammation" . Two patients had VKH symptoms within 1 and 2 weeks after receiving the  ChAdOx1

75-year old man who thought to be the longest-serving inmate in solitary confinement, having survived 43 years in a 6ft x 9ft cell in one of America's most brutal prisons, has died aged 75 from complications caused by Covid-19.   He was released in 2016 on his 69th birthday and went on with his life, wrote a remarkable memoir, won an American book award and was a finalist for the Pulitzer price.  Early July 2022, despite being vaccinated and boosted, he contracted COVID-19. He got better, but started to experience shortness of breath in the end of July and was taken to the hospital. He got fluid in his lungs. It cleared up with medicine, but that aggravated his heart. Once his heart seemed better, his kidney function dwindled. Scans showed that he had developed blood clots and had begun suffering strokes.  Doctors thought he would pull through, but he was intubated and never regained consciousness. REFERENCES https://lailluminator.com/2022/08/04/albert-woodfox-angola-3-member-sol

Subacute thyroiditis (SAT) is a thyroid inflammatory disease associated with viral infections. Its pathogenesis is still unclear.   Several   SAT  cases associated with SARS-CoV-2 infection as well as COVID-19 vaccination have been reported.  A case of a 5 2-year-old female with SAT after the third dose of  COVID-19   mRNA vaccine  BNT162b2 (Pfizer-BioNTech) was documented with laboratory tests and ultrasound examination. She needed therapy during the acute phase and subsequently thyroxine supplementation. A 34-year-old male physician was admitted to the endocrinology outpatient clinic on the 20th day after the first dose of mRNA-1273 vaccination. He reported fatigue, headache, weakness in the lower extremities, sweating, and weight loss, which started 5 days after the first dose of the vaccine; the first symptom was a lump sensation when swallowing. The course of the vaccination and his symptoms are shown in the Figure.  As the patient was a physician, he assumed that his symptoms -

On the morning of September 27 2021, a 17-year-old boy was found dead on the floor beside his bed. The autopsy disclosed a “slightly enlarged heart,” but there was no indication of a cardiac condition at the time.  Father of the boy obtained a second assessment after being dissatisfied with the findings of the initial autopsy and forwarded the autopsy report to “a second well-known pathologist in Canada who wants to remain anonymous for fear of losing his job.” He was informed by the pathologist that “the vaccine did kill [his] son.” Myocarditis and other post-vaccination heart problems are widespread in those who have gotten the Pfizer vaccine, with young males having a substantially higher frequency of post-vaccination heart problems than those who have had a COVID infection. The  teenager had acquired the vaccine in attempt to pursue hockey, due to proof of vaccination obligations imposed by minor hockey clubs across the province. Although the local government at the period did not