Age: 80.0
Sex: M
Vaccine: COVID19
Symptoms: Blood chloride, Blood creatine phosphokinase, Blood creatinine, Blood glucose, Blood lactate dehydrogenase
Clinical narrative: vaccine-related rhabdomyolysis; Weakness; generalized body ache; nausea; episode of vomiting; myalgia; This literature-study case was reported in a literature article and describes the occurrence of RHABDOMYOLYSIS (vaccine-related rhabdomyolysis), ASTHENIA (Weakness), PAIN (generalized body ache), NAUSEA (nausea), VOMITING (episode of vomiting) and MYALGIA (myalgia) in an 80-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.      The patient's past medical history included COVID-19 (3 months prior which required hospitalization for 13 days and treatment with convalescent plasma, remdesivir, and dexamethasone, according to institutional standard treatment protocols at the time.). Concurrent medical conditions included Type II diabetes mellitus (type II diabetes mellitus). Concomitant products included ALOGLIPTIN, EMPAGLIFLOZIN, INSULIN ASPART, INSULIN GLARGINE, LOSARTAN, METFORMIN, PIOGLITAZONE and TAMSULOSIN for an unknown indication.   On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced RHABDOMYOLYSIS (vaccine-related rhabdomyolysis) (seriousness criteria hospitalization and medically significant), ASTHENIA (Weakness) (seriousness criterion hospitalization), PAIN (generalized body ache) (seriousness criteria hospitalization and medically significant), NAUSEA (nausea) (seriousness criterion hospitalization), VOMITING (episode of vomiting) (seriousness criterion hospitalization) and MYALGIA (myalgia) (seriousness criterion hospitalization). At the time of the report, RHABDOMYOLYSIS (vaccine-related rhabdomyolysis), ASTHENIA (Weakness), PAIN (generalized body ache), NAUSEA (nausea), VOMITING (episode of vomiting) and MYALGIA (myalgia) had resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Alanine aminotransferase (0-35): 47 alanine aminotransferase (ALT) 47 U/L. On an unknown date, Aspartate aminotransferase (0-35): 112 aspartate aminotransferase (AST) 112 U/L. On an unknown date, Blood bilirubin (0.2-1.2): 0.8 0.8 mg/dL. On an unknown date, Blood calcium (8.5-10.5): 8.5 8.5mg/dL. On an unknown date, Blood chloride (99-110): 96 96 meq/L. On an unknown date, Blood creatine phosphokinase (30-200): 6546 His serum creatinine kinase (CK) was 6,546 U/L. On an unknown date, Blood creatinine (0.6-1.3): 1.1 1.1 mg/dL. On an unknown date, Blood glucose (70-100): 219 219 mg/dL. On an unknown date, Blood lactate dehydrogenase (125-245): 359 lactate dehydrogenase (LDH) 359 U/L. On an unknown date, Blood potassium (3.7-5.1): 3.6 potassium 3.6 meq/L. On an unknown date, Blood pressure measurement: 120/70 blood pressure of 120/70 mmHg. On an unknown date, Blood sodium (135-145): 130 130 meq/L. On an unknown date, Blood urea (6-24): 23 blood urea nitrogen (BUN) 23 mg/dL. On an unknown date, Body temperature: 98.4 temperature of 98.4° F. On an unknown date, C-reactive protein (0.0-8.0): 146.8 C-reactive protein (CRP) 146.8 mg/dL. On an unknown date, Electrocardiogram: negative (Negative) An electrocardiogram (EKG) was negative for ischemia. On an unknown date, Haemoglobin (13-15): 13.3 Hemoglobin 13-15 g/dL. On an unknown date, Heart rate: 87 beats per minute heart rate of 87/minute. On an unknown date, Platelet count (140-420): 145 145 x 103/mcL. On an unknown date, Red blood cell count (4.6-6.8): 4.6 RBC 4.6-6.8 x 106/mcL. On an unknown date, Red blood cell sedimentation rate (0-19): 52 erythrocyte sedimentation rate (ESR) 52 mm/Hr. On an unknown date, Respiratory rate: 16 breaths per minute 16 breaths per minute. On an unknown date, SARS-CoV-2 test: negative (Negative) COVID-19 PCR were negative. On an unknown date, Troponin: negative (Negative) Troponins, a respiratory polymerase chain reaction (PCR) panel including influenza, and COVID-19 PCR were negative. On an unknown date, White blood cell count (3.6x 103-10.3x 103): 6.2 WBC 3.6-10.3 x 103/mcL.     For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered RHABDOMYOLYSIS (vaccine-related rhabdomyolysis), ASTHENIA (Weakness), PAIN (generalized body ache), NAUSEA (nausea), VOMITING (episode of vomiting) and MYALGIA (myalgia) to be possibly related.    Patient developed generalized body aches, nausea, and an episode of vomiting the next day of second dose administration. He denied any fevers or chills. Patient was diabetic and denied trauma, recent surgery, strenuous exercise, alcohol use, or illicit drug use. He was not taking medications known to cause rhabdomyolysis including statins. No infections were identified. His serum glucose level was not elevated to a level that would point to a hyperosmolar hyperglycemic state. The Naranjo Score was 6, which indicates the rhabdomyolysis was probably an adverse reaction to vaccination. Patient received IV fluids overnight. His CK improved over the course of his hospital stay, and he did not develop significant acute kidney injury or electrolyte abnormalities. The patient regained his ability to ambulate independently, had improved myalgias, and was discharged in stable condition  This literature case concerns a 80-year-old, male with a medical history of Covid-19 and type 2 DM, who experienced the unexpected serious events of rhabdomyolysis, pain, asthenia, nausea, myalgia and vomiting. The events occurred after receiving Moderna mRNA-1273 vaccine. The rechallenge is not applicable as the events occurred only after first or second dose. The reporter assessed the causality as related. The benefit-risk relationship of mRNA-1273 vaccine in not affected by this report.; Sender's Comments: This literature case concerns a 80-year-old, male with a medical history of Covid-19 and type 2 DM, who experienced the unexpected serious events of rhabdomyolysis, pain, asthenia, nausea, myalgia and vomiting. The events occurred after receiving Moderna mRNA-1273 vaccine. The rechallenge is not applicable as the events occurred only after first or second dose. The reporter assessed the causality as related. The benefit-risk relationship of mRNA-1273 vaccine in not affected by this report.