A Case of de novo MPO-associated Central Nervous System Vasculitis Following Heterogeneous mRNA1273 COVID-19 Booster Vaccination

The coronavirus disease-19 (COVID-19) pandemic leaded to inevitable expeditious vaccine rollout without sufficient safety profile. Especially, severe acute respiratory syndrome coronavirus 2 infection has known to induce overreacted immune responses such as releasing of proteinase-3 and myeloperoxidase (MPO) by neutrophil. This overreacted immune response leads to the concern of the development of autoimmune diseases after COVID-19 vaccination. We report the case of de novo MPO-associated systemic vasculitis involving central nervous system following heterogeneous mRNA1273 COVID-19 booster vaccination.

The Impact of Tinnitus on Fibromyalgia

Objective@#. Fibromyalgia (FM) is a disorder characterized by chronic diffuse pain and enhanced pain response to stimuli and is caused by central sensitization. Tinnitus also is related to central sensitization. So we investigated the impact of tinnitus on FM. @*Methods@#. We included 22 FM patients with tinnitus and 25 FM patients without tinnitus. We assessed a range of symptoms using the Widespread Pain Index; Symptom Severity Score scale; Visual Analogue Scale of pain; and the Korean versions of the Fibromyalgia Impact Questionnaire (FIQ), the Insomnia Severity Index, and the Short-form Health Survey (SF-36). Information about the severity of tinnitus in FM patients was evaluated using the Korean version of the Tinnitus Handicap Questionnaire (THQ-K). @*Results@#. There were significant differences between the group that had mild tinnitus (THQ＜38) and the group that had moderate-to-severe tinnitus (THQ≥38) for FIQ score (p=0.025) and for the physical functioning (p=0.003), social functioning (p=0.035), and mental health (p=0.017) components of the SF-36. Also, after dividing patients into 2 groups according to insomnia severity, significant differences were observed in FIQ score (p=0.002) and in body pain (p=0.001), general health (p=0.008), vitality (p=0.003), social functioning (p=0.003), role limitation due to emotional condition (p=0.001), and mental health (p＜0.001) components of the SF-36. @*Conclusion@#. The FM patients with severe tinnitus had more functional impairments and lower quality of life than those with mild tinnitus. Severe insomnia also was accompanied by worse health status and lower quality of life.