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      COVID‐19 vaccine‐induced vasculitis in a patient with sarcoidosis: A case report

      case-report

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          Abstract

          A 55‐year‐old lady with a nine‐year history of controlled sarcoidosis developed vasculitis after Sinopharm COVID‐19 vaccine (BBIBP‐ CorV). She was ultimately diagnosed with mononeuritis multiplex based on EMG‐NCV findings and administered methylprednisolone and cyclophosphamide pulse therapy for 5 days, and then continue with prednisolone and a monthly pulse of cyclophosphamide.

          Abstract

          Vaccination, as a factor alone or in combination with disease agents, can cause new or aggravate pre‐existing symptoms, such as vasculitis among sarcoidosis patients.

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          Most cited references36

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          Immunological considerations for COVID-19 vaccine strategies

          Mangalakumari Jeyanathan, Sam Afkhami, Fiona Mary Smaill … (2020)
          The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the most formidable challenge to humanity in a century. It is widely believed that prepandemic normalcy will never return until a safe and effective vaccine strategy becomes available and a global vaccination programme is implemented successfully. Here, we discuss the immunological principles that need to be taken into consideration in the development of COVID-19 vaccine strategies. On the basis of these principles, we examine the current COVID-19 vaccine candidates, their strengths and potential shortfalls, and make inferences about their chances of success. Finally, we discuss the scientific and practical challenges that will be faced in the process of developing a successful vaccine and the ways in which COVID-19 vaccine strategies may evolve over the next few years.
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            Cutaneous Reactions Reported after Moderna and Pfizer COVID-19 Vaccination: A Registry-Based Study of 414 Cases

            Devon E McMahon, Erin Amerson, Misha Rosenbach … (2021)
            Background Cutaneous reactions after mRNA-based COVID-19 vaccines have been reported but are not well characterized. Objective To evaluate morphology and timing of cutaneous reactions after mRNA COVID-19 vaccines. Methods A provider-facing registry-based study collected cases of cutaneous manifestations after COVID-19 vaccination. Results From December 2020-February 2021, we recorded 414 cutaneous reactions to mRNA COVID-19 vaccines from Moderna (83%) and Pfizer (17%). Delayed large local reactions were most common, followed by local injection site reactions, urticarial eruptions, and morbilliform eruptions. Forty-three percent of patients with first dose reactions experienced second dose recurrence. Limitations Registry analysis does not measure incidence. Morphologic misclassification is possible. Conclusion We report a spectrum of cutaneous reactions after COVID-19 mRNA vaccines. Most patients with first dose reactions did not develop a second dose reaction, and no patients in the registry developed serious adverse events after the first or second dose. These data provide reassurance to patients and providers.
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              2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases

              Victoria Furer, Christien Rondaan, Marloes Heijstek … (2019)
              To update the European League Against Rheumatism (EULAR) recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases (AIIRD) published in 2011. Four systematic literature reviews were performed regarding the incidence/prevalence of vaccine-preventable infections among patients with AIIRD; efficacy, immunogenicity and safety of vaccines; effect of anti-rheumatic drugs on the response to vaccines; effect of vaccination of household of AIIRDs patients. Subsequently, recommendations were formulated based on the evidence and expert opinion. The updated recommendations comprise six overarching principles and nine recommendations. The former address the need for an annual vaccination status assessment, shared decision-making and timing of vaccination, favouring vaccination during quiescent disease, preferably prior to the initiation of immunosuppression. Non-live vaccines can be safely provided to AIIRD patients regardless of underlying therapy, whereas live-attenuated vaccines may be considered with caution. Influenza and pneumococcal vaccination should be strongly considered for the majority of patients with AIIRD. Tetanus toxoid and human papilloma virus vaccination should be provided to AIIRD patients as recommended for the general population. Hepatitis A, hepatitis B and herpes zoster vaccination should be administered to AIIRD patients at risk. Immunocompetent household members of patients with AIIRD should receive vaccines according to national guidelines, except for the oral poliomyelitis vaccine. Live-attenuated vaccines should be avoided during the first 6 months of life in newborns of mothers treated with biologics during the second half of pregnancy. These 2019 EULAR recommendations provide an up-to-date guidance on the management of vaccinations in patients with AIIRD.
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                Author and article information

                Contributors
                Majid Alikhani: alikhanim@sina.tums.ac.ir
                Journal
                Journal ID (nlm-ta): Clin Case Rep
                Journal ID (iso-abbrev): Clin Case Rep
                Journal ID (doi): 10.1002/(ISSN)2050-0904
                Journal ID (publisher-id): CCR3
                Title: Clinical Case Reports
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Electronic): 2050-0904
                Publication date (Electronic): 02 December 2022
                Publication date Collection: December 2022
                Volume: 10
                Issue: 12 ( doiID: 10.1002/ccr3.v10.12 )
                Electronic Location Identifier: e6501
                Affiliations
                [ 1 ] Department of Rheumatology Hormozgan University of Medical Sciences Bandar Abbas Iran
                [ 2 ] Department of Internal Medicine, School of Medicine, Rheumatology Research Center, Shariati Hospital Tehran University of Medical Sciences Tehran Iran
                [ 3 ] Resident of Neurology, Department of Neurology, Shariati Hospital Tehran University of Medical Sciences Tehran Iran
                [ 4 ] School of Medicine Fasa University of Medical Sciences Shiraz Iran
                [ 5 ] School of Medicine Shiraz University of Medical Sciences Shiraz Iran
                [ 6 ] Thoracic and Vascular Surgery Research Center Shiraz University of Medical Sciences Shiraz Iran
                [ 7 ] Joint Reconstruction Research Center Tehran University of Medical Sciences Tehran Iran
                [ 8 ] Rheumatology Research Center Tehran University of Medical Sciences Tehran Iran
                Author notes
                [*] [* ] Correspondence

                Majid Alikhani, Department of Internal Medicine, School of Medicine, Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

                Email: alikhanim@ 123456sina.tums.ac.ir

                Author information
                https://orcid.org/0000-0002-3887-8623
                https://orcid.org/0000-0001-5454-495X
                Article
                Publisher ID: CCR36501 Other ID: CCR3-2022-05-0996.R1
                DOI: 10.1002/ccr3.6501
                PMC ID: 9718919
                SO-VID: 8bef9005-efcc-443f-bc31-0b35ebc66d40
                Copyright © © 2022 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.
                License:

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                Date revision received : 29 September 2022
                Date received : 04 May 2022
                Date accepted : 09 October 2022
                Page count
                Figures: 3, Tables: 1, Pages: 6, Words: 3100
                Categories
                Subject: Case Report
                Subject: Case Report
                Custom metadata
                source-schema-version-number 2.0
                cover-date December 2022
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_JATSPMC version:6.2.1 mode:remove_FC converted:03.12.2022

                Keywords: adverse effects,cutaneous vasculitis,mononeuritis multiplex,sarcoidosis,sars‐cov‐2,sinopharm covid‐19 vaccine
                Data availability:
                Keywords: adverse effects, cutaneous vasculitis, mononeuritis multiplex, sarcoidosis, sars‐cov‐2, sinopharm covid‐19 vaccine

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