Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Biopsy, Computerised tomogram, Condition aggravated, Pulmonary function test, Sarcoidosis
Clinical narrative: sarcoidosis exacerbation; sarcoidosis exacerbation; This literature-non-study case was reported in a literature article and describes the occurrence of SARCOIDOSIS (sarcoidosis exacerbation) in a 59-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below.   LITERATURE REFERENCE:     Concurrent medical conditions included Sarcoidosis.  In 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In 2021, the patient experienced SARCOIDOSIS (sarcoidosis exacerbation) (seriousness criterion medically significant) and CONDITION AGGRAVATED (sarcoidosis exacerbation). The patient was treated with PREDNISONE (oral) for Uveitis, at a dose of 60 milligram once a day; PREDNISONE (oral) from 2016 to 2018 for Uveitis, at an unspecified dose and frequency; METHOTREXATE from 2016 to 2018 for Uveitis, at an unspecified dose and frequency and METHOTREXATE for Uveitis, at an unspecified dose and frequency. At the time of the report, SARCOIDOSIS (sarcoidosis exacerbation) and CONDITION AGGRAVATED (sarcoidosis exacerbation) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): In 2016, Biopsy: diagnosed with sarcoidosis in 2016 after presenting with uveitis and undergoing an endobronchial ultrasound guided biopsy of his enlarged hilar lymph nodes. In 2016, Computerised tomogram: CT chest did not show any parenchymal changes. In 2018, Computerised tomogram: Repeat CT chest in August 2018 showed stable mediastinal adenopathy with very minimal parenchymal involvement. In 2021, Computerised tomogram: CT chest demonstrated new peribronchovascular upper lobe predominant consolidation and nodularity in a perilymphatic distribution and thoracic adenopathy consistent with sarcoidosis. In 2021, Pulmonary function test: Pulmonary function tests were performed after one week on steroids and showed FVC 5.10 L (109%) and a DLCO 93%. FVC, while normal, was significantly reduced from his prior value in 2017 of 5.49L. No ambulatory desaturation was noted..   The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered SARCOIDOSIS (sarcoidosis exacerbation) and CONDITION AGGRAVATED (sarcoidosis exacerbation) to be related.    No concomitant medication were reported.  Company Comment:  This literature non-study case concerns a 59-year-old male patient with relevant medical history of Sarcoidosis, who experienced the unexpected, serious (medically significant) event of Sarcoidosis (reported as sarcoidosis exacerbation) on an unknown date after receiving the first dose of mRNA-1273 vaccine. Onset latency could not be established as date of vaccination and date of event onset were not provided. Two weeks following vaccination, patient was diagnosed with mild uveitis and presented with respiratory symptoms of cough and shortness of breath. Physical examination was normal, chest computerized tomography demonstrated new peribronchovascular, upper lobe predominant consolidation and nodularity in a perilymphatic distribution, and thoracic adenopathy consistent with sarcoidosis. Pulmonary function tests performed after a week of steroids was normal but was significantly reduced from the value taken 4 years prior. No ambulatory desaturation was noted. Blood count, renal and hepatic function tests were unremarkable. Prednisone 60 mg orally once daily was started followed by methotrexate. The second dose (unspecified brand) COVID-19 vaccination was delayed and given 5 months later. Previous occurrence of Sarcoidosis manifested as uveitis (the most common ocular symptom of sarcoidosis) 5 years prior, and as stable mediastinal adenopathy with very minimal parenchymal involvement 3 years prior (immunosuppressants free in the last 3 years) could cause flare ups, and thus remains a confounder. According to the author, Molecular mimicry between the spike protein and the patient's self-peptides or an immune reaction to one of the adjuvant compounds could be the underlying cause of these flares. The benefit-risk relationship of mRNA-1273 Vaccine is not affected by this report.; Sender's Comments: This literature non-study case concerns a 59-year-old male patient with relevant medical history of Sarcoidosis, who experienced the unexpected, serious (medically significant) event of Sarcoidosis (reported as sarcoidosis exacerbation) on an unknown date after receiving the first dose of mRNA-1273 vaccine. Onset latency could not be established as date of vaccination and date of event onset were not provided. Two weeks following vaccination, patient was diagnosed with mild uveitis and presented with respiratory symptoms of cough and shortness of breath. Physical examination was normal, chest computerized tomography demonstrated new peribronchovascular, upper lobe predominant consolidation and nodularity in a perilymphatic distribution, and thoracic adenopathy consistent with sarcoidosis. Pulmonary function tests performed after a week of steroids was normal but was significantly reduced from the value taken 4 years prior. No ambulatory desaturation was noted. Blood count, renal and hepatic function tests were unremarkable. Prednisone 60 mg orally once daily was started followed by methotrexate. The second dose (unspecified brand) COVID-19 vaccination was delayed and given 5 months later. Previous occurrence of Sarcoidosis manifested as uveitis (the most common ocular symptom of sarcoidosis) 5 years prior, and as stable mediastinal adenopathy with very minimal parenchymal involvement 3 years prior (immunosuppressants free in the last 3 years) could cause flare ups, and thus remains a confounder. According to the author, Molecular mimicry between the spike protein and the patient's self-peptides or an immune reaction to one of the adjuvant compounds could be the underlying cause of these flares. The benefit-risk relationship of mRNA-1273 Vaccine is not affected by this report.