Endocrine Abstracts

Introduction: COVID-19 is a pandemic related to SARS-COV-2 virus infection. It is most often manifested by an influenza-like syndrome with other symptoms that are more specific such as loss of smell and taste. Its severity is highly variable, ranging from asymptomatic to severe or prolonged forms. We report the case of a 47-year-old female patient, who is being followed for hypoparathyroidism, who developed severe and persistent cramps after the COVID-19 vaccine.

Observation: This is a 47-year-old female patient with a history of high-risk papillary thyroid carcinoma since 2018, operated and irradiated. Her surgery was complicated by supplementary hypoparathyroidism. Her blood calcium was well controlled and she was asymptomatic since her supplementation with Alfacalcidol and calcium.

She received the first dose of astrazeneca in July 2021, after 4 hours she developed persistent painful cramps in her extremities. Her clinical examination did not reveal any signs of hypocalcaemia and the biological dosage was 84 mg/l. As the cramps persisted, we started her on calcium and magnesium. The clinical evolution was good after 6 hours and there was no recurrence.

Discussion: COVID-19 vaccines are as well tolerated in neuromuscular patients as in the general population (1). Hypoparathyroidism is not a neuromuscular disease, but it can be caused by hypocalcaemia, which is the cause of the neuromuscular manifestations. Campesium can be seen with COVID-19 vaccines, and is generally benign and transient. The particularity of our observation is that the cramps were severe and incapacitating with the need for intravenous calcium treatment and monitoring, adding the hypoparathyroid terrain which posed a problem of differential diagnosis.

Conclusion: The vaccine against COVID-19 has become an unavoidable necessity in the face of the pandemic population. It certainly has short and long term side effects. Fragile patients must be monitored to avoid complications, particularly neuromuscular ones.

References: (1) Neuromuscular diseases and covid-19 vaccination, Recommendations of the filnemus rare diseases health sector, Version 1.0 of 4 January 2021.