"Abstract
... We described a case of an 80-year-old male who developed rhabdomyolysis two days after receiving his second dose of the Moderna COVID-19 vaccine. He presented with severe weakness, myalgias, and an initial creatinine kinase (CK) of 6,546 IU/L that improved with intravenous fluids. Common causes of rhabdomyolysis were excluded including statin use, strenuous exercise, and trauma. With the increasing immunization efforts against COVID-19, physicians should consider the possibility of rhabdomyolysis when a patient presents with neuromuscular complaints following vaccination.
Case Presentation
... Given the timeline of events, lack of alternate explanation, and known correlation of COVID-19 and rhabdomyolysis, the patient was felt to have vaccine-related rhabdomyolysis. The Naranjo score is a causality assessment tool validated to determine the likelihood of an adverse drug reaction. For this patient, positive findings included the adverse event that appeared after the drug was given, the adverse event improved after the drug was discontinued, alternative causes were ruled out, and objective evidence of the adverse event was available (CK). The Naranjo Score was 6, which indicates the rhabdomyolysis was probably an adverse reaction to vaccination...
Discussion
... Several reports of rhabdomyolysis secondary to other vaccinations have also been reported, most commonly to influenza vaccination. A potential mechanism of rhabdomyolysis after vaccination is an exaggerated immune response to adjuvants. This has been previously described as autoimmune/inflammatory syndrome induced by adjuvants (ASIA), which is the spectrum of autoimmune phenomena that are induced following the exposure to external factors with adjuvant activity. It can lead to inflammatory sequela such as rhabdomyolysis. In this case report, our patient received the vaccine despite a prior history of COVID-19 infection. It is unclear, yet possible that the previous infection affected his reaction to the vaccination."
© Copyright 2021
Mack et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.