Radiation recall pneumonitis after <scp>COVID</scp>‐19 vaccination

Shinada, Kanako; Murakami, Shuji; Yoshida, Daisaku; Saito, Haruhiro

doi:10.1111/1759-7714.14239

Cited by 12 publications

(3 citation statements)

References 4 publications

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“…33 A case of RRP has been reported after COVID-19 vaccination by Shinada et al In this case, acute pneumonitis developed in a previously irradiated field post-vaccination, one year after the last dose of irradiation. 34 Another case of RRP triggered by COVID-19 vaccination was reported by Steber et al in a patient with oligometastatic non-small cell lung cancer who had previously undergone local consolidation radiotherapy to the right lung and mediastinum. In this case, the patient complained of pneumonitis with symptoms similar to those of COVID-19 pneumonia, including dry cough, low-grade fever, and shortness of breath.…”

Section: Discussionmentioning

confidence: 94%

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Radiation Recall Pneumonitis COVID-19 Infection Induced After Adjuvant Breast Cancer Radiotherapy. A Known Phenomenon in an Unknown Pandemic Disease: A Case Report

Lazzari¹,

Giua²,

Verdolino³

et al. 2022

CMAR

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The COVID-19 pandemic has opened several new disease scenarios, yielding novel syndromes that have never been seen before and resurrecting old inflammatory phenomena that are no longer recorded, such as radiation recall (RR) syndromes. Radiation recall syndrome is a limited field inflammatory reaction that occurs in a volume that was irradiated several months or years previously before being induced by a triggering factor. The most frequently reported phenomena are skin reactions; however, other organs could be involved, such as the lungs in radiation recall pneumonitis (RRP). It is a well-described inflammatory reaction that occurs within a pulmonary volume that was irradiated several months or years previously via radiotherapy (RT), triggered by factors such as drugs, including chemotherapy agents, immunotherapy, or vaccination. Indeed, during the COVID-19 pandemic, RRP following anti-COVID-19 vaccination or SARS-CoV2 infection was recently reported. ACE receptor-rich tissues such as lung or skin tissues were mainly involved. Herein, we present a case of RRP triggered by COVID-19 pulmonary infection in a woman who previously underwent adjuvant breast cancer radiotherapy. Although symptoms were typical, pulmonary CT findings depicted a unique distribution of ground-glass opacities (GGOs) throughout the previous radiation portals and mirror-like the radiation fields. Anamnesis and radiation plan evaluation were crucial in the diagnosis of RRP.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Radiation Recall Pneumonitis COVID-19 Infection Induced After Adjuvant Breast Cancer Radiotherapy. A Known Phenomenon in an Unknown Pandemic Disease: A Case Report

Lazzari¹,

Giua²,

Verdolino³

et al. 2022

CMAR

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“…Several hypotheses have been put forward to explain the post-infection occurrence of these attacks, which are either druginduced or are not part of the cytokine storm induced by COVID-19, likely to cause recall pneumopathies. The spike protein's role in these attacks is sometimes evoked, mainly since booster pneumopathies have also been described in patients vaccinated against COVID-19 without any concomitant COVID-19 infection [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Drug‐induced radiation recall reactions and non‐anticancer drugs: A descriptive analysis from VigiBase®

Aubin-Beale¹,

Giorgi

Beurrier³

et al. 2023

Fundamemntal Clinical Pharma

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Radiation recall reactions are inflammatory reactions confined to previously irradiated tissues, often of drug‐induced etiology, particularly with anticancer therapies. Other drugs, in particular COVID‐19 vaccines, may also be involved. To describe radiation recall reactions under non‐anticancer drugs more precisely, we extracted the cases of radiation recall reactions associated with non‐anticancer drugs from WHO pharmacovigilance database VigiBase®. We performed two analyses from this extraction: a global analysis and an analysis focusing on vaccination‐related issues. We extracted 120 cases corresponding to 269 drugs, of which 130 were non‐anticancer (22 vaccines). Among the non‐anticancer drugs, tozinameran was the most reported treatment (4.46% of cases), followed by levofloxacin (2.97%) and folinic acid (2.60%), dexamethasone (2.23), and ChAdOx1 nCoV‐19 vaccine and prednisone (1.86% each). Among vaccines, tozinameran (54.55% of cases) was the most reported, followed by ChAdOx1 nCoV‐19 (22.73%), HPV and inactivated influenza vaccine (9.09% each), and elasomeran (4.55%). Our study first describes the occurrence of radiation recall reactions during non‐anticancer treatment. It also highlights a potential safety signal with COVID‐19 vaccines.

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Recognizing cisplatin as a potential radiation recall trigger: case report and focused systematic review

et al. 2023

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We present a case of mild radiation recall dermatitis triggered by cisplatin chemotherapy given simultaneously to re-irradiation. The dermatitis area correlated to skin exposure of the previous radiation therapy, characterizing the reaction clearly as a recall. Cisplatin has not yet been recognized as a potential trigger for recall reactions. Although it was part of several reported multidrug trigger combinations, all review works referred to cisplatin as not suspicious, suggesting the combination partner as the effector. We performed a focused systematic literature review aiming to re-evaluate the real role of cisplatin as a (co-)triggering factor. In total, 30 reported cases were found, 90% triggered by multidrug combinations. The latter tended to cause more severe symptoms. Besides findings supporting the 20 Gy-threshold theory, no correlation between radiation dose and severity or prevalence was found. Recognition of cisplatin as a trigger of the recall phenomenon and its supportive management may prevent unnecessary cessation of systemic chemotherapy. Systematic reporting of recall events as a secondary endpoint of prospective clinical trials applying radiation therapy could support understanding the recall phenomenon.

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Radiation recall pneumonitis after COVID‐19 vaccination

Cited by 12 publications

References 4 publications

Radiation Recall Pneumonitis COVID-19 Infection Induced After Adjuvant Breast Cancer Radiotherapy. A Known Phenomenon in an Unknown Pandemic Disease: A Case Report

Radiation Recall Pneumonitis COVID-19 Infection Induced After Adjuvant Breast Cancer Radiotherapy. A Known Phenomenon in an Unknown Pandemic Disease: A Case Report

Drug‐induced radiation recall reactions and non‐anticancer drugs: A descriptive analysis from VigiBase®

Recognizing cisplatin as a potential radiation recall trigger: case report and focused systematic review

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