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New-onset Adult-onset Still's Disease Following COVID-19 Vaccination: Three Case Reports and a Literature Review
Mayumi Matsuda1, Yu Funakubo Asanuma1, Kazuhiro Yokota1
1Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Japan.
Insights
COVID-19 vaccination may trigger adult-onset Still's disease (AOSD), a rare inflammatory condition. Early diagnosis and treatment with standard therapies led to successful outcomes in all reported cases, suggesting manageable risks.
Area of Science:
- Immunology
- Vaccinology
- Rheumatology
Background:
- Widespread COVID-19 vaccination campaigns aim to prevent severe disease.
- Limited data exist on the long-term safety and potential adverse events of COVID-19 vaccines.
- Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology.
Approach:
- The study reports three new cases of de novo AOSD following COVID-19 vaccination.
- A comprehensive literature review was conducted to identify additional cases of AOSD post-vaccination.
- Clinical data from the three cases and the literature were analyzed.
Key Points:
- Three patients developed new-onset, moderate-to-severe adult-onset Still's disease after COVID-19 vaccination.
- Two of these cases were complicated by macrophage activation syndrome.
- A total of 17 cases (3 original + 14 literature) of new-onset or relapsed AOSD post-COVID-19 vaccination were identified.
Conclusions:
- COVID-19 vaccination may be a potential trigger for adult-onset Still's disease.
- All identified cases of AOSD, including those following vaccination, responded successfully to established treatment regimens.
- Treatment involved glucocorticoids, immunosuppressive drugs, or biologic agents, indicating that AOSD post-vaccination is manageable.
Abstract:
Since December 2020, coronavirus disease 2019 (COVID-19) vaccines have been distributed in most countries to prevent the onset and aggravation of COVID-19. There is little information regarding the long-term safety of the vaccines. We report three cases and a literature review of new-onset adult-onset Still's disease (AOSD) that occurred following COVID-19 vaccination. Our cases include moderate to severe AOSD, and two were complicated with macrophage activation syndrome. Seventeen cases of new-onset or relapse of AOSD following COVID-19 vaccination, including 14 identified in the literature review and our 3 patients, were all treated successfully with glucocorticoid therapy, immunosuppressive drugs, or biologic agents.
