Showing posts from December, 2023

G6PD Mutation & Vaccine Complications

A 72-year-old patient presenting with an inguinal mass and a history of asthma and edema, received two doses of the COVID-19 vaccine in 2021. Approximately two weeks after the second dose, he developed a myriad of symptoms, including dyspnea, palpitations, and edema. Despite local clinic treatments, the symptoms worsened, eventually leading to a diagnosis of retroperitoneal dedifferentiated liposarcoma. The diagnostic journey involved chest CT scans, pleural punctures, and biopsies. The patient's unique case posed challenges, with initial treatments providing only temporary relief. The situation escalated, prompting further examinations and a switch to anlotinib treatment.  Three days after discharge, the patient faced a recurrence of symptoms, leading to a critical discovery — a severe G6PD deficiency. This revelation unfolded through whole exome sequencing, shedding light on a genetic predisposition that played a pivotal role in the patient's adverse reactions.  The authors h

Severe Breakthrough COVID-19 in CAR T-cell treated patient

A 51-year-old woman, with anemia and rib fractures, diagnosed with IgG-kappa multiple myeloma (MM) in 2012, initially achieved complete remission. However, in 2020, she experienced a clinical relapse followed by a biochemical relapse. In 2021, she received two doses of the mRNA vaccine BNT162b2 against SARS-CoV-2, yielding no serological response. Subsequently, before undergoing CAR T-cell therapy, she received a third vaccine boost in March. Two months later, in July 2022, she contracted a SARS-CoV-2 infection, presenting with a dry cough and low-grade fever. Due to relapsed/refractory multiple myeloma (R/R MM), the patient underwent various treatments, including CAR T-cell therapy. Despite achieving minimal residual disease negativity post-infusion, she developed severe COVID-19 pneumonia, posing challenges to her clinical management.  Her prolonged hospitalization was marked by a complex interplay of factors: pulmonary embolism, immune deficiencies including B-cell aplasia and lymph

Pilomatricoma at COVID-19 Vaccination Sites

Pilomatrixoma, pilomatricoma, or calcifying epithelioma of Malherbe, is a common benign tumor originating from hair follicles. It has been noted to develop at COVID-19 vaccination sites. Case 1: Pilomatricoma Post-First COVID-19 Vaccination  A 65-year-old man experienced a growing pilomatricoma on his left upper arm, coinciding with the site of his initial COVID-19 vaccine. The tumor, appearing three months after vaccination, was 3 cm in diameter, mobile, and infection-free. Surgical removal confirmed pilomatricoma, identified by basaloid cells and keratinization. No recurrence was noted three months following surgery. Case 2: Subcutaneous Tumor Following COVID-19 Vaccination In this instance, a 43-year-old Japanese woman developed a subcutaneous tumor at her COVID-19 vaccination site. The tumor, emerging immediately post-vaccination, grew over five months. Dermatological examination showed a distinct, multilocular tumor with redness, and ultrasound imaging revealed a hypoechoic mass.

COVID-19: November 2023 insights

At a Congressional hearing on November 30, CDC Director Dr. Mandy Cohen highlighted a post-Thanksgiving rise in COVID-19 cases, a trend supported by wastewater monitoring.  The innovative  wastewater reporting dashboard , rolled out  in November ,  revamped by the CDC team "Poo's Clues," using SARS-CoV-2 viral RNA concentrations in wastewater, offer insights into the virus's spread, covering over 100 million people across 700+ sites.  A 12% increase in COVID-19 cases was observed from mid- to end of October, with regional variations. The Midwest and West saw significant surges, contrasting with the relative stability in the Northeast and South. By the end of November, West seemingly peaked but then continued upward, Northeast started catching up with Midwest, and numbers kept climbing nationwide  (another 11% increase by the end of November). ( Biobot data show even larger growth  in SARS Cov-2 number, ILInet also reports increasing levels of  influenza-like illness