Two flares of Still’s disease after two doses of the ChAdOx1 vaccine

Roongta, Rashmi; Mondal, Sumantro; Haldar, Subhankar; Kumar, Mavidi Sunil; Ghosh, Alakendu

doi:10.1007/s10067-022-06124-z

Cited by 9 publications

(7 citation statements)

References 34 publications

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“…In certain cases, genetic studies may be useful to exclude hereditary autoinflammatory diseases, but do not show sufficient diagnostic precision to be routinely recommended in AOSD work-up [12,31,42,97,189,211]. From a diagnostic perspective, it is noteworthy that flares or primary manifestations of AOSD have been noted in temporal relation to COVID vaccinations during the course of the current pandemic [99,123,145,159,172,212]. Concerning therapeutic options, the board decided against phrasing a recommendation for or against tumor necrosis factor (TNF)-blocking agents.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of adult-onset Still’s disease: a concise summary of the German society of rheumatology S2 guideline

et al. 2022

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Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of adult-onset Still’s disease: a concise summary of the German society of rheumatology S2 guideline

et al. 2022

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“…The two-fold higher incidence of AOSD in Vac cohort compared with the primary cohort supports the assumption of a connection between AOSD and COVID-19 vaccination. Even though it is not sufficiently clear how vaccines could influence AOSD [20], some authors have described several assumptions regarding the causes. For example, there are a few cases in which AOSD occurred after the patients had received other vaccines, such as for influenza [21,22].…”

Section: Discussionmentioning

confidence: 99%

“…We speculate that the immune response regarding the SARS-CoV-2 infection is even stronger due to prior COVID-19 vaccination. Based on the literature, the second dose of the COVID-19 vaccine could lead to severe AOSD flares due to the stronger immune response to the second dose [20]. Furthermore, booster vaccinations seem to cause an enhanced immune response compared with Fig.…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of adult-onset Still’s disease in association with COVID-19 vaccination and SARS-CoV-2 infection

Gottschalk

Heiland

Nahles

et al. 2023

Orphanet J Rare Dis

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Background Adult-onset Still’s disease (AOSD) is a multi-system, auto-inflammatory disease characterized by fever, arthralgia, typical rash, leukocytosis, sore throat, and liver dysfunction, among other symptoms. Retrospective studies about the frequencies of AOSD have shown that this disease is very rare. However, there has been an increased scientific interest in the last 2 years, as numerous case studies on AOSD have been published. These case studies describe the occurrence of AOSD after SARS-CoV-2 infection and/or COVID-19 vaccination. Methods We analyzed the incidence of AOSD to examine a potential association between AOSD and SARS-CoV-2 infection and/or COVID-19 vaccination. The TriNetX dataset consists of 90 million patients. We found 8474 AOSD cases, which we analyzed regarding SARS-CoV-2 infection and/or vaccination status. We also analyzed the cohorts considering demographic data, lab values, co-diagnoses and treatment pathways. Results We divided the AOSD cases into four cohorts: primary cohort (AOSD), Cov cohort (AOSD + SARS-CoV-2 infection), Vac cohort (AOSD + COVID-19 vaccination) and Vac + Cov cohort (AOSD + COVID-19 vaccination + SARS-CoV-2 infection). For the primary cohort, we found an annual incidence of 0.35 per 100.000. We found an association between AOSD and SARS-CoV-2 infection and/or COVID-19 vaccination. According to the numerical analysis, the incidence of AOSD doubled for the Cov cohort and Vac cohort. Moreover, the incidence of AOSD was 4.82 times higher for Vac + Cov cohort. The lab values for inflammatory markers were increased. Co-diagnoses such as rash, sore throat, and fever appeared in all AOSD cohorts, with the highest occurrences in the AOSD + COVID-19 vaccination + SARS-CoV-2 infection cohort. We identified several lines of treatments, mainly in association with adrenal corticosteroids. Conclusions This research supports the assumption of an association between AOSD and SARS-CoV-2 infection and/or COVID-19 vaccination. However, AOSD remains a rare disease and the usage of vaccines to fight the COVID-19 pandemic should not be questioned because of the increased incidence of AOSD.

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“…Additionally, the possibility of the flare-up of existing AOSD should not be excluded in this group of patients. A series of case reports has shown that the administration of the COVID-19 vaccine could induce a robust immune response [ 16 , 17 , 18 , 19 , 20 ]. Existing autoimmune diseases might relapse due to the robust immune response triggered by the administration of the vaccine.…”

Section: Discussionmentioning

confidence: 99%

Adult-Onset Still’s Disease following Coronavirus 2 (SARS-CoV-2) Vaccination: A Case Report

2022

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In recent years, during the ravages of COVID-19, a variety of vaccines have been developed and are now on the market. However, although these new vaccines have undergone various trials, there are still many unknown side effects. We report a case of a 30-year-old woman who presented with general weakness, sore throat, generalized skin rashes, symmetrical arthralgia, and persistent fever of up to 40 °C with onset 16 days after receiving the Moderna COVID-19 vaccine. Adult-onset Still’s disease (AOSD) was diagnosed according to Yamaguchi’s criteria after excluding the feasibility of infectious diseases, autoimmune diseases, and malignancies. In particular, her responses to glucocorticoids and naproxen were significant and inversely proportional to her use of empirical antibiotics in the initial stage of treatment. We studied some similar cases of AOSD, which also considered the adverse effects of COVID-19 vaccination and suggested the immunogenicity and possibility of inflammatory responses related to COVID-19 vaccination.

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Two flares of Still’s disease after two doses of the ChAdOx1 vaccine

Cited by 9 publications

References 34 publications

Diagnosis and treatment of adult-onset Still’s disease: a concise summary of the German society of rheumatology S2 guideline

Diagnosis and treatment of adult-onset Still’s disease: a concise summary of the German society of rheumatology S2 guideline

Increased incidence of adult-onset Still’s disease in association with COVID-19 vaccination and SARS-CoV-2 infection

Adult-Onset Still’s Disease following Coronavirus 2 (SARS-CoV-2) Vaccination: A Case Report

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