Age: 58.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Electromyogram, Glycosylated haemoglobin, Hypoaesthesia, Magnetic resonance imaging
Clinical narrative: Left neuralgic amyotrophy; Possible musculoskeletal adverse events; Developed patches of numbness over her forearm; Left shoulder pain; This literature-non-study case was reported in a literature article and describes the occurrence of NEURALGIC AMYOTROPHY (Left neuralgic amyotrophy) and MUSCULOSKELETAL DISORDER (Possible musculoskeletal adverse events) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.   LITERATURE REFERENCE:      Concurrent medical conditions included Type 2 diabetes mellitus (Patient had a history of type 2 diabetes that is not well controlled.).    In April 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In May 2021,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced ARTHRALGIA (Left shoulder pain). On an unknown date, the patient experienced NEURALGIC AMYOTROPHY (Left neuralgic amyotrophy) (seriousness criterion medically significant), MUSCULOSKELETAL DISORDER (Possible musculoskeletal adverse events) (seriousness criterion medically significant) and HYPOAESTHESIA (Developed patches of numbness over her forearm). The patient was treated with Physical therapy for Neuralgic amyotrophy; Physical therapy for Musculoskeletal disorder; Physical therapy for Hypoaesthesia and Physical therapy for Arthralgia. At the time of the report, NEURALGIC AMYOTROPHY (Left neuralgic amyotrophy), MUSCULOSKELETAL DISORDER (Possible musculoskeletal adverse events), HYPOAESTHESIA (Developed patches of numbness over her forearm) and ARTHRALGIA (Left shoulder pain) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Electromyogram: abnormal (abnormal) An EMG was performed which was consistent with left neuralgic amyotrophy (brachial plexitis or Parsonage-Turner Syndrome). On an unknown date, Glycosylated haemoglobin: 13.0 (High) 13.0 two months before (normal <6.0). On an unknown date, Magnetic resonance imaging: abnormal (abnormal) An MRI of the left shoulder performed 17 days after vaccination demonstrated a 30 mm paralabral cyst associated with the anterior glenoid labrum.. On an unknown date, Physical examination: abnormal (abnormal) No atrophy on physical examination but was hypersensitive to light touch over the arm and forearm. Active forward elevation was to 60 degrees..     The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered NEURALGIC AMYOTROPHY (Left neuralgic amyotrophy), MUSCULOSKELETAL DISORDER (Possible musculoskeletal adverse events), HYPOAESTHESIA (Developed patches of numbness over her forearm) and ARTHRALGIA (Left shoulder pain) to be related.    Patient presented with left shoulder pain in mid-May 2021. She took the first dose of vaccine 33 days prior to her clinic visit. After the first dose of vaccine she developed immediate pain that worsened over time. She could no longer raise her shoulder, and she subsequently developed patches of numbness over her forearm.  Company comment: This literature-non-study case concerns a 58-year-old female patient, with medical history of type 2 diabetes mellitus, who experienced the serious (due to medically significant) unexpected events of NEURALGIC AMYOTROPHY and MUSCULOSKELETAL DISORDER, among other non-serious events. The events were reported with no onset date; hence, latency to the first dose of mRNA-1273 vaccine. As per source document, she developed immediate pain that worsened over time, and she had as a significant comorbidity an uncontrolled insulin dependent diabetes mellitus. It is not clear if this played a role in her reaction to the vaccine, as uncontrolled diabetes is well known to adversely impact several other organ systems including vascular system, and peripheral nervous system. The reporter stated that this type of nervous system reaction is not necessarily specific to mRNA vaccines, but her presentation illustrates the concept that an mRNA vaccine can have an impact on the immune system, leading to complications. The benefit-risk relationship of the mRNA-1273 is not affected by this report.   This case was linked to MOD-2022-461943 (Patient Link).   Most recent FOLLOW-UP information incorporated above includes: On 05-May-2022: Follow up received by safety on 05-May-2022 has Email received from team and contains significant information. Literature information, seriousness and events were updated. Sender's Comments: This literature-non-study case concerns a 58-year-old female patient, with medical history of type 2 diabetes mellitus, who experienced the serious (due to medically significant) unexpected events of NEURALGIC AMYOTROPHY and MUSCULOSKELETAL DISORDER, among other non-serious events. The events were reported with no onset date; hence, latency to the first dose of mRNA-1273 vaccine. As per source document, she developed immediate pain that worsened over time, and she had as a significant comorbidity an uncontrolled insulin dependent diabetes mellitus. It is not clear if this played a role in her reaction to the vaccine, as uncontrolled diabetes is well known to adversely impact several other organ systems including vascular system, and peripheral nervous system. The reporter stated that this type of nervous system reaction is not necessarily specific to mRNA vaccines, but her presentation illustrates the concept that an mRNA vaccine can have an impact on the immune system, leading to complications. The benefit-risk relationship of the mRNA-1273 is not affected by this report.