Syndrome of inappropriate antidiuretic hormone and status epilepticus associated with mRNA-based SARS-CoV-2 vaccination

Yang, Ji Won; Kim, Yeo Reum; Hong, Yu Ah

doi:10.1007/s11255-022-03451-7

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…There were no signs of inflammation, pulmonary lesions, or other factors causing SIADH, and the time course suggested that SIADH could be related to vaccination. In previous case reports similar to the present case, it has been postulated that the increase in inflammatory cytokines such as C-reactive protein (CRP) and interleukin (IL)-6 induced by vaccination stimulates antidiuretic hormone secretion (7). Furthermore, another study in mice showed that SARS-CoV-2 mRNA vaccination induces escalation of plasma IL-6 levels (8).…”

Section: Discussionsupporting

confidence: 79%

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Severe hyponatremia with consciousness disturbance after receiving SARS-CoV-2 mRNA vaccination

Kumagai,

Koyama,

Yorozu

et al. 2023

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary There are very few reports of syndrome of inappropriate antidiuresis hormone secretion (SIADH) after receiving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine. Herein, we present the case of an 84-year-old woman who developed severe hyponatremia following the second administration of the SARS-CoV-2 mRNA vaccine. The patient presented with nausea, vomiting, and headache. Laboratory tests showed a plasma sodium level of 119 mmol/L. After receiving 500 mL of intravenous saline over a 2-h period, her plasma sodium level raised to 121 mmol/L, but her symptoms persisted. Considering that rapid plasma sodium correction was necessary, we started 3% saline solution overnight. Her plasma sodium level raised to 132 mmol/L and her symptoms completely resolved. Clinical and laboratory findings were consistent with a diagnosis of SIADH. In the absence of any other triggering factors, we concluded that the condition was likely associated with the vaccination. Clinicians should be aware of the potential for hyponatremia, particularly SIADH, associated with SARS-CoV-2 mRNA vaccination. Learning points Reports of syndrome of inappropriate antidiuresis hormone secretion after receiving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination are limited. If nausea, headache, and confusion are observed immediately after SARS-CoV-2 vaccination, clinicians should consider the presence of hyponatremia. As similar case reports to date have presented with severe hyponatremia, prompt treatment may be required.

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Section: Discussionsupporting

confidence: 79%

“…To date, several cases of SIADH associated with coronavirus disease 2019 have been reported, and the mechanism is being elucidated ( 2 ). On the other hand, reports of SIADH associated with vaccination are very few ( 3 , 4 , 5 , 6 , 7 ). We experienced the case of severe hyponatremia after receiving SARS-CoV-2 mRNA vaccination.…”

Section: Discussionmentioning

confidence: 99%

Severe hyponatremia with consciousness disturbance after receiving SARS-CoV-2 mRNA vaccination

Kumagai,

Koyama,

Yorozu

et al. 2023

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Pituitary and COVID-19 vaccination: a systematic review

Verrienti,

Marino Picciola,

Ambrosio

et al. 2024

Pituitary

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Purpose This systematic review aims to examine the latest research findings and assess the impact of COVID-19 vaccination on the pituitary gland. Method PubMed and Tripdatabase were searched from January 1st, 2020 to February 12th, 2024. Case reports, case series and reviews related to post COVID-19 vaccination pituitary disease were included. Eligible articles were tabulated and analysed in the attempt to provide an overview on the epidemiology, clinical presentation, imaging, treatment, outcomes and pathophysiological background of post COVID-19 vaccination pituitary disease. Results Among the 23 case reports included in this review, post COVID-19 vaccination hypophysitis was reported in 9 patients, pituitary apoplexy (PA) in 6 cases, SIADH in 5 cases and Isolated ACTH deficiency in 2 cases. Additionally, precipitating adrenal crisis was registered in 7 patients and pituitary tumor enlargement in 1 patient after receiving COVID-19 vaccination. Conclusion Despite the rarity of these events, our research findings suggest an association between COVID-19 vaccination and the subsequent development of pituitary diseases. The most common manifestations include hypophysitis with ADH deficiency, PA and SIADH, with symptoms typically emerging shortly after vaccine administration. Potential pathogenetic mechanisms include molecular mimicry, vaccine adjuvants and vaccine-induced thrombotic thrombocytopenia (VITT), with the presence of ACE2 receptors in the hypothalamus-pituitary system contributing to the process. These findings can aid in diagnostic and treatment decisions for patients presenting with these syndromes. Nevertheless, given the rarity of these events, safety and efficacy of the currently available COVID-19 vaccines remain robust and we strongly advocate continuing pursuing vaccination efforts.

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Tozinameran

2023

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Syndrome of inappropriate antidiuretic hormone and status epilepticus associated with mRNA-based SARS-CoV-2 vaccination

Cited by 4 publications

References 8 publications

Severe hyponatremia with consciousness disturbance after receiving SARS-CoV-2 mRNA vaccination

Severe hyponatremia with consciousness disturbance after receiving SARS-CoV-2 mRNA vaccination

Pituitary and COVID-19 vaccination: a systematic review

Tozinameran

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