Reşit YILDIRIM, Döndü ÜSKÜDAR CANSU, Mustafa DİNLER, Cengiz KORKMAZ

COVİD-19 Aşıları Romatizmal Hastalığı Tetikleyebilir veya Alevlendirebilir; 4 Vakalık Derleme

Aşılama, COVİD-19 pandemisinin kontrol altına alınmasında önemli bir köşe taşı rolü oynamıştır. Özellikle SARS-CoV2’ye karşı geliştirilen mRNA bazlı yeni aşılar, romatizmal hastalığı olan populasyonda yeterli randomize kontrollü çalışmaları olmaması sebebiyle, hem romatologlar hem de otoimmun hastalığı olanlarda hastalığın alevlenmesi, ya da ek bir otoimmun hastalığın ortaya çıkması hususunda endişelere yol açmıştır. Teorik olarak immun hiperaktivasyona yol açabileceği düşünülse de pandeminin bu hasta grubundaki riski göz önüne alınarak aşılama uygulamalarına devam edilmiştir. Literatürde romatizmal hastalığı olanlarda aşı sonrası aktivasyon olduğuna dair gözlemsel veriler mevcuttur. Öte yandan aşı ilişkili olduğu düşünülen yeni tanı otoimmun hastalıklar olgu bildirileri şeklinde yayınlanmaktadır. Burada romatoloji kliniğimizde mRNA aşısı sonrası ortaya çıkan ve alevlenme ile başvuran 4 hasta sunduk.

Anahtar Kelimeler:

COVİD19, mRNA aşıları, immun hiperaktivasyon, otoimmun hastalıklar

COVID-19 Vaccines Can Initiate or Exacerbate A Rheumatic Disease; A Report of 4 Cases

Vaccination has been playing an anchor role in controlling the COVID-19 pandemic. Notably, mRNA-based novel vaccines against SARS-CoV2 have increased some speculations among rheumatologists and patients with autoimmune disorders, whether they may reactivate the presenting disease or unveil a new autoimmune disease because of the absence of randomized controlled tirals pioneering their effects in this specific population. Despite these theoretical concerns on immune hyperactivation, vaccination has been performed widespreadly because benefits outweigh mortality risks in this population. Recent observational studies showed that disease flares are seen in rheumatic diseases after vaccination. On the other hand, case reports and case series have been increasingly published that autoimmune disorders may be emerged following vaccination. Herein, we report 4 cases including flares and an occurence of rheumatic disease after mRNA vaccination.

Keywords:

COVID19, mRNA vaccines, immune hyperactivation, autoimmune disorders,

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