Polymyalgia rheumatica following respiratory syncytial virus (RSV) vaccination
  • Mohamad El Labban
    Department of Internal Medicine, Mayo Clinic Health System, Mankato, USA
  • Stevan Oluic
    Department of Internal Medicine, Mayo Clinic Health System, Mankato, USA
  • Hussein Guleid
    Department of Internal Medicine, Mayo Clinic Health System, Mankato, USA
  • Mohamed Hassan
    Department of Internal Medicine, Mayo Clinic Health System, Mankato, USA
  • Rawan Diab
    School of Medicine, American University of Beirut, Beirut, Lebanon
  • Mohamad Ali Rida
    Lebanese American University of Medicine, Byblos, Lebanon

Keywords

Polymyalgia rheumatica, RSV vaccine, vaccine-related adverse event

Abstract

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.

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References

  • Acharya S, Musa R. Polymyalgia Rheumatica. [Updated 2024 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537274/
  • Liozon E, Ouattara B, Rhaiem K, Ly K, Bezanahary H, Loustaud V et al. Familial aggregation in giant cell arteritis and polymyalgia rheumatica: a comprehensive literature review including 4 new families. Clin Exp Rheumatol 2009;27:S89-94.
  • Uddhammar A, Boman J, Juto P, Rantapää Dahlqvist S. Antibodies against Chlamydia pneumoniae, cytomegalovirus, enteroviruses and respiratory syncytial virus in patients with polymyalgia rheumatica. Clin Exp Rheumatol 1997;15:299-302.
  • Soriano A, Verrecchia E, Marinaro A, Giovinale M, Fonnesu C, Landolfi R et al. Giant cell arteritis and polymyalgia rheumatica after influenza vaccination: report of 10 cases and review of the literature. Lupus 2012;21:153-157.
  • Lemoine C, Padilla C, Krampe N, Doerfler S, Morgenlander A, Thiel B et al. Systemic lupus erythematous after Pfizer COVID-19 vaccine: a case report. Clin Rheumatol 2022;41:1597-1601.
  • Chen Y, Xu Z, Wang P, Li XM, Shuai ZW, Ye DQ et al. New-onset autoimmune phenomena post-COVID-19 vaccination. Immunology 2022;165:386-401.
  • Langmuir AD. Guillain-Barré syndrome: the swine influenza virus vaccine incident in the United States of America, 1976-77: preliminary communication. J R Soc Med 1979;72:660-669.
  • Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ, Keenlyside RA, Ziegler DW, Retailliau HF et al. Guillain-Barre syndrome following vaccination in the National Influenza Immunization Program, United States, 1976--1977. Am J Epidemiol 1979;110:105-123.
  • Siddiqi N, Gulati G, Ware AE. Polymyalgia Rheumatica and Autoimmune Inflammatory Syndrome Induced by Adjuvants Following Administration of Influenza Vaccine. J Clin Rheumatol 2018;24:410-412.
  • Naranjo CA, Busto U, Sellers EM, Sandor P, Ruiz I, Roberts EA et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 1981;30:239-245.
  • Soriano A, Nesher G, Shoenfeld Y. Predicting post-vaccination autoimmunity: who might be at risk? Pharmacol Res 2015;92:18-22.
  • Bassendine MF, Bridge SH. Relapse of polymyalgia rheumatica following adjuvanted influenza vaccine: A case-based review. Eur J Rheumatol 2019;7:37-40.
  • Falsetti P, Conticini E, Acciai C, Baldi C, Bardelli M, Gentileschi S et al. Polymyalgia rheumatica following infective triggers or vaccinations: a different subset of disease? Reumatologia 2020;58:76-80.
  • Kanduc D. Molecular Mimicry between Respiratory Syncytial Virus F Antigen and the Human Proteome. Glob Med Genet 2023;10:19-21.
  • Patricia Lloyd, S.P. 2024; Available from: https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2024-02-28-29/06-RSV-Adults-Lloyd--508.pdf.

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    Published: 2024-06-27
    Issue: 2024: LATEST ONLINE (view)

    How to cite:
    1.
    El Labban M, Oluic S, Guleid H, Hassan M, Diab R, Rida MA. Polymyalgia rheumatica following respiratory syncytial virus (RSV) vaccination. EJCRIM 2024;11 doi:10.12890/2024_004636.