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New onset of protein-losing enteropathy in a patient with Fontan circulation after COVID-19 vaccination: dread the cure or the disease?

Published online by Cambridge University Press:  27 January 2025

Polona Kacar Open the ORCID record for Polona Kacar [Opens in a new window] ,
Giulia Iannaccone ,
Ella McDonnell  and
Claudia Montanaro
Polona Kacar*
Affiliation:
Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’s NHS Foundation Trust, Imperial College, London, UK
Giulia Iannaccone
Affiliation:
Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’s NHS Foundation Trust, Imperial College, London, UK Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
Ella McDonnell
Affiliation:
Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’s NHS Foundation Trust, Imperial College, London, UK
Claudia Montanaro
Affiliation:
Adult Congenital Heart Centre and National Centre for Pulmonary Hypertension, Royal Brompton and Harefield Hospitals, Guy’s and St Thomas’s NHS Foundation Trust, Imperial College, London, UK National Heart and Lung Institute, Imperial College, London, UK Department of Cardiac Surgery, Cardiology and Heart Lung Transplant, Bambino Gesu’ Children’s Hospital IRCCS, Rome, Italy
*
Corresponding author: Polona Kacar; Email: [email protected]
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Abstract

We present the case of a 31-year-old female with Fontan circulation who developed signs of protein-losing enteropathy 10 days after second COVID-19 vaccination. After standard investigations for identification of potential triggers for protein-losing enteropathy, we concluded that coronavirus disease 2019 (COVID-19) booster vaccination could have been the most probable underlying trigger. Prompt investigation of new symptoms post-vaccination in high-risk patients is necessary.

Keywords

Adult CHDFontan circulationprotein-losing enteropathyCOVID-19vaccination
Type
Brief Report
Information
Cardiology in the Young , First View , pp. 1 - 3
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Copyright
© The Author(s), 2025. Published by Cambridge University Press

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References

Atz, AM, Zak, V, Mahony, L, et al. Longitudinal outcomes of patients with single ventricle after the Fontan procedure. J Am Coll Cardiol 2017; 69: 2735–2744.CrossRefGoogle ScholarPubMed
Barracano, R, Merola, A, Fusco, F, Scognamiglio, G, Sarubbi, B. Protein-losing enteropathy in Fontan circulation: pathophysiology, outcome and treatment options of a complex condition. Int J Cardiol Congenit Hear Dis 2022; 7: 100322.Google ScholarPubMed
Lenz, D, Hambsch, J, Schneider, P, et al. Protein-losing enteropathy in patients with Fontan circulation: is it triggered by infection? Crit Care 2003; 7: 185–190.CrossRefGoogle ScholarPubMed
Sindet-Pedersen, C, Michalik, F, Strange, JE, et al. Risk of worsening heart failure and all-cause mortality following COVID-19 vaccination in patients with heart failure: a nationwide real-world safety study. Circ Hear Fail 2023; 16: 859–869.Google ScholarPubMed
Khan, MZ, Janus, S, Franklin, S, Figueredo, V, Baqi, A, Alvarez, R. COVID-19 vaccination-induced cardiomyopathy requiring permanent left ventricular assist device. Cureus 2022; 14: 1–4.Google ScholarPubMed
Fusco, F, Scognamiglio, G, Merola, A, et al. Coronavirus disease 2019 in patients with Fontan circulation. Int J Cardiol Congenit Hear Dis 2021; 3: 100126.Google ScholarPubMed
Wen, C, Shi, G, Liu, W, Zhang, H, Lin, G, Chen, H. COVID-19 in a child with transposition of the great arteries S/P Fontan palliation: a case report and literature review. Front Cardiovasc Med 2022; 9: 1–6.CrossRefGoogle Scholar
Terentes-Printzios, D, Gardikioti, V, Solomou, E, et al. The effect of an mRNA vaccine against COVID-19 on endothelial function and arterial stiffness. Hypertens Res 2022; 45: 846–855.CrossRefGoogle ScholarPubMed
John, AS, Johnson, JA, Khan, M, Driscoll, DJ, Warnes, CA, Cetta, F. Clinical outcomes and improved survival in patients with protein-losing enteropathy after the Fontan operation. J Am Coll Cardiol 2014; 64: 54–62.CrossRefGoogle ScholarPubMed
Goldberg, DJ, Dodds, K, Avitabile, CM, et al. Children with protein-losing enteropathy after the Fontan operation are at risk for abnormal bone mineral density. Pediatr Cardiol 2012; 33: 1264–1268.CrossRefGoogle ScholarPubMed
Morsheimer, MM, Rychik, J, Forbes, L, et al. Risk factors and clinical significance of Lymphopenia in survivors of the Fontan procedure for single-ventricle congenital cardiac disease. J Allergy Clin Immunol Pract 2016; 4: 491–496.CrossRefGoogle ScholarPubMed
Alsaied, T, Rathod, RH, Aboulhosn, JA, et al. Reaching consensus for unified medical language in Fontan care. ESC Hear Fail 2021; 8: 3894–3905.CrossRefGoogle ScholarPubMed
Zaltsberg, GS, Lam, CZ, Ling, SC, et al. Magnetic resonance liver lymphangiography for investigation and transhepatic lymphatic embolization for the treatment of protein-losing enteropathy. J Vasc Interv Radiol 2021; 32: 327–329.e2.CrossRefGoogle ScholarPubMed