3 research outputs found
Case Report: Severe Rhabdomyolysis and Multiorgan Failure After ChAdOx1 nCoV-19 Vaccination
Background: Severe skeletal muscle damage has been recently reported in patients with
SARS-CoV-2 infection and as a rare vaccination complication.
Case summary: On 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.
Conclusion: Physicians should be aware that severe and fatal rhabdomyolysis may occur
after SARS-CoV2 vaccine administration
A rare association of early-onset inclusion body myositis, rheumatoid arthritis and autoimmune thyroiditis: a case report and literature review
Sporadic inclusion body myositis (sIBM) is a slowly progressive, red-rimmed vacuolar myopathy leading to muscular atrophy and progressive weakness; it predominantly affects males older than fifty years, and is resistant to immunotherapy. It has been described in association with immuno-mediated thrombocytopenic purpura,
multiple sclerosis, connective tissue disorders and, occasionally, rheumatoid arthritis. A 37-year-old man with longstanding rheumatoid arthritis and autoimmune thyroiditis with hypothyroidism was referred to us with slowly progressive, diffuse muscle weakness and wasting, which had initially involved the volar finger flexors, and
subsequently also the ankle dorsiflexors and knee
extensors. Needle electromyography showed typical myopathic motor unit potentials, fibrillation and positive sharp waves with normal nerve conduction studies. Quadriceps muscle biopsy was suggestive of sIBM. Considering data published in the literature, this case may be classified as an early-onset form. The patient was treated with
long-term intravenous immunoglobulin and obtained a substantial stabilization of his muscle strength