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 hypothesized that the patient, having received the second vaccination, experienced cytokine storm triggered by an immune response due to G6PD deficiency. This resulted in the development of a severe systemic inflammatory response syndrome, distinct from the type I allergy (allergic reaction) observed after the initial vaccination. Currently, there are documented cases of acute hemolysis following vaccination in individuals with G6PD deficiency and thalassemia, attributed to an oxidative stress reaction triggered by the immunization process.

G6PD (Glucose-6-Phosphate Dehydrogenase) deficiency is associated with a spectrum of health effects, including anemia, hemolysis, inflammatory infections, and cardiovascular disease. However, this deficiency demonstrates dual effects when it comes to anti-tumor treatment. An aberrant upswing in G6PD activity has been observed to enhance the proliferation of tumor cells, instigate tumor angiogenesis, and fortify resistance against radiotherapy and cytotoxic drugs. 


REFERENCE

Xu W, Nian W. A rare adverse effects of COVID-19 vaccine in a patient with a latent tumor: A case report and literature review. Front Oncol. 2023 Dec 5;13:1269735. doi: 10.3389/fonc.2023.1269735. PMID: 38115902; PMCID: PMC10728639. pdf

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