Rhabdomyolysis after recombinant zoster vaccination: a rare adverse reaction

Rajaratnam, Nishan; Govil, Swati; Patel, Rutwik; Ahmed, Mohamed; Elias, Sameh

doi:10.1080/20009666.2020.1841878

Cited by 11 publications

(15 citation statements)

References 9 publications

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“…However, detection of SARS-CoV-2 infection in skeletal muscle cells has not been established yet ( 16 ). Rhabdomyolysis secondary to vaccination has previously been reported, mostly in the context of influenza vaccination ( 17 , 18 ). In association with COVID-19 mRNA vaccination, the onset of fatigue, myalgias, and arthralgias following mRNA vaccination has been reported in a considerable subset of patients ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: ANCA-Associated Vasculitis Presenting With Rhabdomyolysis and Pauci-Immune Crescentic Glomerulonephritis After Pfizer-BioNTech COVID-19 mRNA Vaccination

Hakroush

Tampe

2021

Front. Immunol.

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As the coronavirus disease 2019 (COVID-19) pandemic is ongoing and new variants of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are emerging, there is an urgent need for COVID-19 vaccines to control disease outbreaks by herd immunity. Surveillance of rare safety issues related to these vaccines is progressing, since more granular data emerge with regard to adverse events of COVID-19 vaccines during post-marketing surveillance. Interestingly, four cases of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) presenting with pauci-immune crescentic glomerulonephritis (GN) after COVID-19 mRNA vaccination have already been reported. We here expand our current knowledge of this rare but important association and report a case of AAV presenting with massive rhabdomyolysis and pauci-immune crescentic GN after Pfizer-BioNTech COVID-19 mRNA vaccination. As huge vaccination programs are ongoing worldwide, post-marketing surveillance systems must continue to assess vaccine safety important for the detection of any events associated with COVID-19 vaccination. This is especially relevant in complex diseases where diagnosis is often challenging, as in our patient with AAV presenting with massive rhabdomyolysis and pauci-immune crescentic GN.

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Section: Discussionmentioning

confidence: 99%

Case Report: ANCA-Associated Vasculitis Presenting With Rhabdomyolysis and Pauci-Immune Crescentic Glomerulonephritis After Pfizer-BioNTech COVID-19 mRNA Vaccination

Hakroush

Tampe

2021

Front. Immunol.

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“…Venous thrombo-embolism in unusual sites with a fatal outcome has been occasionally reported ( 9 ). Following vaccinations, a few cases of rhabdomyiolysis in patients receiving influenza, varicella zoster and, more recently, also following mRNA vaccination, have been documented ( 10 , 12 ). A severe rhabdomyolysis following COVID-19 AstraZeneca vaccine has been described in a patient with Carnitine palmitoyltransferase II (CPT II) deficiency, a disorder of long-chain fatty acid oxidation (FAO), caused by mutations in the CPT2 gene ( 11 ).…”

Section: Discussionmentioning

confidence: 99%

“…Rhabdomyolysis has been reported as a rare vaccination complication after influenza A H1N1 vaccine, and recombinant zoster immunization ( 10 ). Furthermore, a severe form of rhabdomyolysis after a COVID-19 AstraZeneca vaccine has been reported in a young patient who also had a carnitine palmitoyltransferase II (CPT II) deficiency ( 11 ), in a 21-year-old male with a history of asthma after the first dose of the Pfizer/BioNTech COVID-19 vaccine and more recently in a patient who also developed anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) and pauci-immune crescentic glomerulonephritis after two doses of Pfizer-BioNTech COVID-19 mRNA vaccination ( 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Case Report: Severe Rhabdomyolysis and Multiorgan Failure After ChAdOx1 nCoV-19 Vaccination

Cirillo¹,

Esposito²,

Giardino³

et al. 2022

Front. Immunol.

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BackgroundSevere skeletal muscle damage has been recently reported in patients with SARS-CoV-2 infection and as a rare vaccination complication.Case summaryOn Apr 28, 2021 a 68-year-old man who was previously healthy presented with an extremely severe rhabdomyolysis that occurred nine days following the first dose of SARS-CoV-2 ChAdOx1 nCov-19 vaccination. He had no risk factors, and denied any further assumption of drugs except for fermented red rice, and berberine supplement. The clinical scenario was complicated by a multi organ failure involving bone marrow, liver, lung, and kidney. For the rapid increase of the inflammatory markers, a cytokine storm was suspected and multi-target biologic immunosuppressive therapy was started, consisting of steroids, anakinra, and eculizumab, which was initially successful resulting in close to normal values of creatine phosphokinase after 17 days of treatment. Unfortunately, 48 days after the vaccination an accelerated phase of deterioration, characterized by severe multi-lineage cytopenia, untreatable hypotensive shock, hypoglycemia, and dramatic increase of procalcitonin (PCT), led to patient death.ConclusionPhysicians should be aware that severe and fatal rhabdomyolysis may occur after SARS-CoV2 vaccine administration.

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“…Several reports of rhabdomyolysis secondary to other vaccinations have also been reported, most commonly to influenza vaccination [ 9 , 10 ]. A potential mechanism of rhabdomyolysis after vaccination is an exaggerated immune response to adjuvants.…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyolysis Secondary to COVID-19 Vaccination

Mack¹,

Nichols²,

Guerrero³

2021

Cureus

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Rhabdomyolysis has been described as a complication of coronavirus disease 2019 (COVID-19) infection, but few cases of rhabdomyolysis associated with COVID-19 vaccination have been reported. We described a case of an 80-year-old male who developed rhabdomyolysis two days after receiving his second dose of the Moderna COVID-19 vaccine. He presented with severe weakness, myalgias, and an initial creatinine kinase (CK) of 6,546 IU/L that improved with intravenous fluids. Common causes of rhabdomyolysis were excluded including statin use, strenuous exercise, and trauma. With the increasing immunization efforts against COVID-19, physicians should consider the possibility of rhabdomyolysis when a patient presents with neuromuscular complaints following vaccination.

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Rhabdomyolysis after recombinant zoster vaccination: a rare adverse reaction

Cited by 11 publications

References 9 publications

Case Report: ANCA-Associated Vasculitis Presenting With Rhabdomyolysis and Pauci-Immune Crescentic Glomerulonephritis After Pfizer-BioNTech COVID-19 mRNA Vaccination

Case Report: ANCA-Associated Vasculitis Presenting With Rhabdomyolysis and Pauci-Immune Crescentic Glomerulonephritis After Pfizer-BioNTech COVID-19 mRNA Vaccination

Case Report: Severe Rhabdomyolysis and Multiorgan Failure After ChAdOx1 nCoV-19 Vaccination

Rhabdomyolysis Secondary to COVID-19 Vaccination

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