Showing posts from February, 2023

Chronic Inflammatory Demyelinating Polyneuropathy After COVID-19 Vaccination

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare autoimmune neurological disorder that affects the peripheral nervous system. Unlike Guillain-BarrĂ© syndrome (GBS) that develops rapidly and reaches its peak within a few weeks, CIDP is a chronic condition that develops more slowly and can last for months or even years. It is characterized by chronic inflammation and damage to the myelin sheath that covers and protects the nerves, leading to symptoms such as weakness, numbness, and tingling in the arms and legs. CIDP is estimated to affect about 1 to 2 people per 100,000 population per year, and it can occur at any age, although it is more common in middle-aged and older adults. Left untreated, 30% of CIDP patients will progress to wheelchair dependence.  A previously healthy 72-year-old man presented with a progressive tingling sensation and weakness below both knees for two weeks that started two weeks after vaccination with the 3rd dose of mRNA-1273. As the symptoms

STAT3-mediated adverse events following immunization with an mRNA vaccine

Genetic factors that increase the risk of COVID-19 vaccine-induced adverse events are currently being investigated. A new article is presenting a case of T-LGL, T-cell large granular lymphoma, a rare lymphoproliferative disorder, in a patient who received a COVID-19 mRNA vaccine. The authors analyzed the results of gene sequencing for pathogenic mutations but did not find any known variations associated with T-LGL, particularly not in STAT3 or STAT5b, harboring the most common gain-of-function mutations. However, the article provides evidence that the vaccine induces STAT3 activation through TLR stimulation, which may potentially exacerbate STAT3-dependent diseases. Interestingly, expansion of T cells causing progressive lymphadenopathy following mRNA vaccination has been reported in a patient with angioimmunoblastic T Cell lymphoma, indicating that further investigation is needed to understand the potential genetic and immune-related factors that increase the risk of lymphoma after va

Polyarteritis Nodosa Following Vaccination

Polyarteritis nodosa (PAN) is a rare, but serious autoimmune disease that affects the medium-sized arteries, can block the flow of blood and nutrients and affect many different organs in the body, including the skin, joints, nerves, kidneys, and gastrointestinal tract.  It is a complex condition with multiple genetic and environmental factors likely playing a role. Genetic factors that have been associated with PAN include variations in MEFV, TNFAIP3, CECR1, DADA2, and ITGB2 genes.  A healthy 59-year-old woman presented to the emergency department with a two-day history of progressively worsening abdominal pain, melena, and postprandial nausea. The patient had no significant chronic medical history and no recent infections. She was recently vaccinated with the second dose of the mRNA-1273 vaccine against SARS-CoV-2 approximately two days before her presentation. Physical examination was significant for diffuse tenderness to palpation of the abdomen with rebound tenderness of the right

Systemic lupus erythematosus myocarditis after COVID-19 vaccination

A 72-year-old female underwent kidney transplantation in 2004 due to a chronic kidney failure secondary to membranoproliferative glomerulonephritis The patient has been in chronic hemodialysis since 2017 after renal graft dysfunction due to chronic rejection. She presented to the emergency room with pleuritic chest pain one week after vaccination with the third dose of BNT162b2 mRNA. Physical examination was unremarkable.  Despite no history of autoimmune diseases, her ANA IFA (a first line screen for detecting the presence of autoantibodies) was positive in 1:160 dilution, anti-dsDNA, and anti-histone antibodies were also positive. FDG PET/CT was requested, showing a focal myocardial and pericardial inflammatory process in the cardiac apex. Given the results, Systemic lupus erythematosus (SLE) diagnosis was made with myocardial affection. She was immediately started on oral prednisone (1 mg/kg) and beta-blockers improving clinically. At the three-month follow-up visit, the patient wa

Necrotizing Encephalitis and Myocarditis after BNT162b2 mRNA Vaccination against COVID-19

76-year-old man with Parkinson's disease (PD) died three weeks after receiving his third COVID-19 vaccination, 5 months after his second dose (BNT162b2 mRNA vaccine/Comirnaty) and 7 months since his first dose (ChAdOx1 nCov-19 vector vaccine).  On the day of his first vaccination, the individual experienced pronounced cardiovascular side effects, for which he repeatedly had to consult his doctor. After the second vaccination two months later, the family noted obvious behavioral and psychological changes (e.g., he did not want to be touched anymore and experienced increased anxiety, lethargy, and social withdrawal even from close family members). Furthermore, there was a striking worsening of his PD symptoms, which led to severe motor impairment and a recurrent need for wheelchair support. He never fully recovered from these side effects after the first two vaccinations but still got another vaccination in December 2021. Two weeks after the third vaccination, he suddenly collapsed w