Acute Calcium Pyrophosphate Crystal Arthritis of the Wrist Elicited by Anti-COVID-19 Vaccination After Carpal Tunnel Release.
Filippo Andrea Giovanni PerozzoLeonardo PunziAlfio Luca CostaFranco BassettoPublished in: The American journal of case reports (2022)
BACKGROUND Calcium pyrophosphate dihydrate deposition disease includes a variety of clinical syndromes, including acute calcium pyrophosphate (CPP) crystal arthritis. Most patients with CPP crystal arthritis have a primary/idiopathic form presenting with severe pain, swelling, and stiffness. COVID-19 infection, which originated in China in December 2019, required extraordinary efforts to develop and test new vaccines to halt the pandemic. The Vaxzervria vaccine has shown excellent safety and efficacy in phase 3 trials with a mechanism based on the expression of the SARS-CoV-2 spike protein gene coding for the S-antigen, which stimulates the immune response. CASE REPORT We describe an acute event of crystal arthritis after a carpal tunnel syndrome release followed by administration of the second dose of anti-COVID-19 Vaccine Oxford-AstraZeneca (ChAdOx1 nCoV-19). Medical treatment resulted in full resolution of the symptoms in 2 weeks. CONCLUSIONS Although most episodes of acute arthritis happen spontaneously, certain factors may trigger the acute CPP crystal arthritis such as intercurrent illnesses or surgeries. Although the association between carpal tunnel syndrome and CPP arthritis has been known for over 40 years, surgical release of the carpal ligament has always been associated with full resolution of symptoms. This is the first case report describing an exacerbation after carpal canal release, concomitant with the administration of the vaccine. According to our opinion, the vaccination associated with a prior surgery in the same anatomical site could have synergically triggered the arthritis flare-up, in a predisposed patient, with a mechanism still unknown.
Keyphrases
- sars cov
- rheumatoid arthritis
- liver failure
- case report
- respiratory failure
- coronavirus disease
- drug induced
- aortic dissection
- immune response
- chronic obstructive pulmonary disease
- respiratory syndrome coronavirus
- chronic pain
- spinal cord injury
- coronary artery disease
- gene expression
- intensive care unit
- acute coronary syndrome
- dna methylation
- transcription factor
- early onset
- physical activity
- toll like receptor
- long non coding rna
- neuropathic pain
- copy number
- depressive symptoms
- quality improvement
- smoking cessation
- dendritic cells
- preterm birth
- surgical site infection
- genome wide
- inflammatory response