Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) became a major concern since the announcement that it is a pandemic in early 2020. Vaccine trials were started in November 2020, and completed rapidly due to the urgency to get over the infection. Side effects to vaccines started to be reported. There were minor side effects including site of injection pain and heaviness and constitutional symptoms like fever which are considered minor. One of the rare adverse events is post vaccine new onset autoimmune diseases. Methods: Data were obtained from one center in the eastern province of Saudi Arabia (King Fahd Hospital of University). All patient events reported occurred in the study period March 2021 to February 2022. We identified patients presenting with autoimmune diseases with exclusively new onset presentations. Results: We identified 31 cases of immune-mediated disease: 18 females (58%); 13 males (42%). Only 4 of them (13%) had an autoimmune background before COVID-19 vaccination. The average time between vaccination and new-onset disease symptoms was 7 days. Among all the cases in our study, 7 patients (22.5%) had new-onset vasculitis, 2 cases had IgA vasculitis and 5 cases had ANCA vasculitis, 6 cases had neurological diseases (19.3%), 4 cases (12.9%) had new-onset systemic lupus erythematosus (SLE), 3 cases (9.6%) presented with new-onset inflammatory arthritis, and one had Sjogren's syndrome (3.2%). Conclusion:Our study is unique as it is the first study to include the largest number (31 patients) of new onsets of confirmed autoimmune diseases related to Covid-19 vaccines.

Hemophagocytic syndrome (HPS) is characterized by the activation of histiocytes with prominent hemophagocytosis in bone marrow and other reticuloendothelial systems. It has two forms: primary and secondary. The precise pathogenesis of HPS is unclear but a dysregulation of macrophage-lymphocyte interactions with subsequent increases in the levels of both T-cell-derived and macrophagederived cytokines has been suggested. Cardinal symptoms of HPS are prolonged high fever, hepatosplenomegaly, cytopenias, lymphadenopathy and neurological symptoms. In this report, we present a case Systemic Lupus Erythematosus associated with HPS and acute pancreatitis. Ó 2014 Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

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The adrenal catécholamines (norepinephrine and epinephrine) and their conversion enzymes (PNMT, COMT) were comparatively investigated in: (1) rats fed a diet deprived of vitamin A, inducing a rapid and severe deficiency; (2) rats fed another diet leading to a more progressive deficiency (rats supplemented with retinol served as controls for these two types of diet), and (3) rats fed a whole industrial diet. The first diet induced a strong accumulation of adrenal catecholamines and increased the activity of PNMT and COMT. The second diet only increased the adrenal content of norepinephrine and epinephrine.