Journal of European Internal Medicine Professionals

Are Allergic Diseases a Risk Factor for Systemic Side Effects After COVID-19 Vaccines?

Emel Atayık — 2024-02-14

Background/Aim: In clinical trials of currently-approved COVID-19 vaccines, patients with a known allergy or a history of anaphylaxis were excluded from the studies. This situation creates doubts about the risk and type of side effects of COVID-19 vaccines in patients with allergic diseases. Therefore, we aimed to evaluate local side effects (LSE) and systemic side effects (SSE) after COVID-19 vaccines in patients with allergic diseases and to determine possible risk factors.

Methods: Between April 1, 2021 and September 30, 2021, 648 adult patients who received any COVID-19 vaccines were included in this case-control retrospective study.

Results: Six hundred forty-eight adult patients [Female: 446 (68.8%), Male: 202 (32.2%)] participated in the study. After the 1^st dose of COVID-19 vaccine, 24.1% of patients reported SSE. After the 2^nd dose of COVID-19 vaccines, 67 patients (12.3%) developed SSE. Female gender (OR: 1.757, 95%Cl: 1.143-2.702, p: 0.010), history of previous COVID-19 infection (OR: 1.762, 95%Cl: 1.068-2.906, p: 0.026), and COVID-19 vaccine type administered (OR: 4.443, 95% CI: 2.640-7.476, p<0.001) were found to be independent risk factors for SSE after COVID-19 vaccines. Premedication (OR: 0.454, 95% Cl: 0.281-0.733, p<0.001), was found to be a protective factor for SSE developing after COVID-19 vaccines.

Conclusion: Systemic side effects against CoronaVac and Pfizer-BioNTech COVID-19 vaccines are very low. Patients with allergic disease do not have an increased risk for SSE that may develop after COVID-19 vaccines. Moreover, doubts or fears about possible side effects in the allergic patient group should not be an obstacle to COVID-19 vaccination.

Neuromuscular Dysfunction and Electrophysiological Findings in Patients With Hypothyroidism and Hyperthyroidism

Arzu Akgül — 2024-02-14

Background: We aimed to determine the frequency of neuropathy and myopathy in newly diagnosed hypothyroid and hyperthyroid patients and to investigate the correlation between serum creatine kinase (CK) concentration and thyroid dysfunction.

Methods: A total of 21 hyperthyroid, 19 hypothyroid, and 20 healthy control subjects were selected for the study. All participants underwent neuromuscular examinations for paresthesia, diffuse pain, muscle cramps, and muscle weakness. Electroneurophysiologic studies were performed on all participants.

Results: Neuromuscular complaints were observed more frequently in the hypothyroid and hyperthyroid groups compared to the control group. Myopathy was detected in 10% of the hypothyroid group and 4% of the hyperthyroid group. Polyphasia potential abnormality was detected in 21% of the hypothyroid group and 14% of the hyperthyroid group. CK elevation was found in 42% of patients in the hypothyroid group and 4% of patients in the hyperthyroid group. There was no correlation between symptoms and CK elevation or between myopathy and thyroid function levels. In the electroneurophysiologic study, 14% neuropathy was found in the hyperthyroidism group and 26% in the hypothyroidism group. In the hypothyroid group, polyneuropathy was found in 10%, and carpal tunnel syndrome was found in 10%. Absence of sensory action potential was found in 10% of the hyperthyroid group and 4% of the hypothyroid group, and low compound muscle action potential was found in 4% of the hyperthyroid group. There was no correlation between thyroid hormone levels and neuropathy.

Conclusion: Neuromuscular complaints and neuropathic findings are highly prevalent in patients with thyroid dysfunction. Neuromuscular symptoms may improve after treatment of thyroid disease. In future studies, comparing post-treatment electrophysiologic values with pre-treatment values and clinical values may more clearly demonstrate the effect of thyroid function on the neuromuscular system.

Keywords: Hypothyroidism, hyperthyroidism, neuromuscular

Prognosis and Risks for Renal Transplant Recipients During the COVID-19 Pandemic

Kadir Gökhan Atılgan — 2024-02-14

Background: We aim to compare potential factors that may affect the prognosis of kidney transplant recipients (KTRs) and hemodialysis patients (HDPs) with the diagnosis of COVID-19.
Method: This single-center retrospective study was conducted at the University of Health Science Diskapi Yildirim Beyazit Training and Research Hospital hospital. From March 1, 2021, to September 30, 2021, 110 individuals diagnosed with COVID-19 and ≥18 years old were included in our study. The study population comprised 29 kidney transplant recipients (KTRs) and 81 hemodialysis patients (HDPs). Data were collected from the hospital’s software and included patient descriptive features, laboratory test results, medication records, demographic information, comorbidities, and clinical outcomes of COVID-19 diagnosis, such as mortality and discharge rates.
Results: A total of 110 patients (29 KTRs, 81 HDPs) were evaluated. There was no significant difference in mortality rates observed between the groups (p=0.117). Coronary artery disease (CAD) was found associated with mortality in both KTRs and HDPs (p=0.001 and p=0.021, respectively). A logistic regression analysis model identified age above 55 years as a significant mortality-related factor in HDPs (p=0.039). Pro-brain natriuretic peptide (pro-BNP) and procalcitonin levels at admission, and increase in serum creatinine, neutrophil count, lactate dehydrogenase (LDH), d-dimer, procalcitonin and urea urea during hospitalization were associated with death in KTRs (p<0.05).
Conclusion: This study highlights comparable mortality rates in KTRs and HDPs hospitalized due to COVID-19. Kidney injury (increase in creatinine, urea), presence of CAD, proBNP, D-dimer, LDH), and inflammation (increase in neutrophil count, procalcitonin) could be a predictor of mortality in KTRS with COVID-19. Despite ongoing debates on immunosuppressive medications, our findings suggest a potential role in mitigating COVID-19 severity. Additionally, age > 55 years is a strong indicator of mortality in HDPs with COVID-19.

Successfully Completed Twin Pregnancy of a Peritoneal Dialysis Patient

Asil Demirezen — 2024-02-14

This is a letter to the editors. An abstract is not available.

A Rare Case of Multiple and Ectopic Parathyroid Adenoma

Fatih Güzel — 2024-02-14

This is a letter to the editors. An abstract is not available

Dyslipidemia and Kidney: An Updated View

Özgür Can — 2024-02-14

Dyslipidemia is a common concern in various kidney-related conditions, including chronic kidney disease, nephrotic syndrome, kidney transplant patients, and those undergoing dialysis. Dyslipidemia is a significant risk factor for atherosclerosis and cardiovascular diseases in these patient groups. Understanding the unique challenges and factors associated with dyslipidemia in these kidney-related conditions is essential for providing effective patient care and reducing cardiovascular risk. This review explores the relationship between dyslipidemia and kidney diseases, highlighting the key recommendations and considerations for managing lipid profiles in each population.

Diagnosis and Treatment of Monogenic Hypertension in Children

Faysal Gök — 2024-02-14

Hypertension (HT) is a common public health problem that develops due to primary and secondary causes. The prevalence of HT in children and adolescents is 3.6%. In childhood HT, complex and polygenic factors such as genetic, environmental, adaptive, neural, and hormonal mechanisms play a role. Among these factors, genetic factors are estimated to contribute to the development of HT by 30-60%; however, known genetic factors explain only 3% of the cases.
Monogenic inherited HT is associated with a mutation in a single gene, with or without the influence of mineralocorticoids, leading to increased sodium reabsorption and intravascular volume expansion. Typically, HT in these patients has an early onset, a family history of HT, is associated with electrolyte imbalance, and shows a clinical course refractory to treatment.
In treating monogenic inherited HT, understanding functional genetic mutations enables the utilization of highly effective pharmacogenetic pathways. This knowledge provides the opportunity to tailor treatments specifically to target the primary pathophysiological mechanism of the condition. Sodium-dependent, low renin levels, and monogenic inherited HT treatment are based on a low-sodium diet and block the pathological sodium reabsorption mechanism.
Diagnosis can be made through physical examination, blood pressure measurement, and measurement of renin, aldosterone, cortisol, and potassium levels. Monogenic inherited HTs are rare. Early diagnosis ensures blood pressure control early on, reducing the morbidity and mortality associated with HT. Genetic tests are necessary to confirm the diagnosis, make a differential diagnosis, and choose appropriate treatment.
Clinical manifestations of monogenic inherited HT in some patients extend beyond HT. Other systemic symptoms may accompany HT or manifest at certain stages of life. This article discusses monogenic inherited HT that manifests in the early stages of life, emphasizing the clinical aspects of HT.