接种呼吸道合胞病毒 (RSV) 疫苗后的多发性风湿痛。

Q3 Medicine
European journal of case reports in internal medicine Pub Date : 2024-06-27 eCollection Date: 2024-01-01 DOI:10.12890/2024_004636
Mohamad El Labban, Stevan Oluic, Hussein Guleid, Mohamed Hassan, Rawan Diab, Mohamad Ali Rida
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引用次数: 0

摘要

引言多发性风湿痛(PMR)是一种慢性炎症性疾病,会导致包括肩部、髋部和颈部在内的近端关节僵硬和疼痛。多发性风湿痛的确切病因尚不完全清楚,但研究表明,遗传和环境因素都可能导致该病。此前有研究表明,多发性风湿痛症状的出现和复发与流感疫苗和 COVID-19 疫苗有关。美国食品和药物管理局于 2023 年 5 月批准了呼吸道合胞病毒(RSV)疫苗,这是一种重组蛋白疫苗,适用于 60 岁以上的成年人。此前没有关于多发性风湿病发病或复发与 RSV 疫苗有关的报道。人类蛋白质组与 RSV F 抗原共享一些肽,这表明在疫苗配方中使用该抗原时存在很高的交叉反应风险:一名 72 岁的男性在接种 Abrysvo® RSV 疫苗三天后再次出现双侧肩膀疼痛和僵硬。症状持续了一个多小时(直到中午),影响了他的日常生活。C反应蛋白等炎症指标升高。泼尼松治疗后,患者的症状和炎症标志物水平明显改善:结论:对于有典型 PMR 症状的患者,临床医生必须仔细审查免疫接种史,以排除任何可能相关的不良反应:本病例报告表明,呼吸道合胞病毒(RSV)疫苗是多发性风湿病的可能诱因之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Polymyalgia Rheumatica Following Respiratory Syncytial Virus (RSV) Vaccination.

Introduction: Polymyalgia rheumatica (PMR) is a chronic inflammatory disorder that causes stiffness and pain in the proximal joints, including the shoulders, hips and neck. The exact cause of polymyalgia rheumatica is yet to be fully understood, but research suggests that both genetic and environmental factors may contribute to it. Studies have previously linked the onset and relapse of polymyalgia rheumatica symptoms to the influenza and COVID-19 vaccines. The Food and Drug Administration approved the respiratory syncytial virus (RSV) vaccine, which is a recombinant protein vaccine for adults over 60, in May 2023. No previous reports of polymyalgia rheumatica onset or relapse have been linked to the RSV vaccine. The human proteome shares some peptides with the RSV F antigen, suggesting a high risk of cross-reactivity when using that antigen in vaccination formulations.

Case description: A 72-year-old man experienced a new onset of bilateral shoulder pain and stiffness three days after receiving the Abrysvo® RSV vaccine. The symptoms lasted more than an hour (up until noon) and interfered with his activities of daily living. Inflammatory markers such as C-reactive protein were elevated. The patient's symptoms and inflammatory marker levels significantly improved with prednisone therapy.

Conclusion: In patients with typical PMR symptoms, it is important for clinicians to carefully review immunisation history to rule out any potentially related adverse effects.

Learning points: Vaccines can trigger autoimmune diseases in some individuals.This case report suggests respiratory syncytial virus (RSV) vaccine is among the possible triggers for polymyalgia rheumatica.

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来源期刊
CiteScore
2.10
自引率
0.00%
发文量
166
审稿时长
8 weeks
期刊介绍: The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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