![]() ![]() In the late phase, there was no significant dermal back flow, but her left inguinal lymph node activity was weak. In the early phase, the main lymphatic vessel of the left lower extremity was weak compared with the contralateral side. ![]() Lymphoscintigraphy was performed after injection of technetium (Tc)-99m phytate colloid into the web space of both feet, and serial images of both lower extremities were obtained at 3, 15, 30, and 60 minutes (Fig. Next, the patient received a related work-up considering the possibility of lymphedema. In addition, no demonstrable enlargement of venous structures in both lower extremities was detected, suggesting no definitive evidence of varicose veins. However, ultrasonographic findings revealed no demonstrable evidence of venous thrombosis along the bilateral common femoral, superficial femoral, popliteal, posterior tibial, peroneal, and anterior tibial veins. Thus, additional Doppler sonography was performed to assess the patient's vessel status. As she was an elderly patient and visited a clinic with sudden symptoms of lower extremity edema, we suspected the possibility of deep vein thrombosis (DVT). In addition, there were no specific abnormalities in urine analysis or other blood parameters, including thyroid function test results. Regarding laboratory evaluation, her serum BUN was 13.6 mg/dL and serum creatinine level was 0.59 mg/dL, suggesting no progression of renal disease. The patient was initially suspected of having heart failure or renal disease, but there were no abnormal findings on echocardiography. The only positive history element was that she had received a second dose of BNT16b2 1 week before the clinic visit. Physical examination revealed no motor or sensory impairment in both lower extremities, but showed limited movement due to leg swelling. This case report was approved by the institutional review board of our facility (protocol number K2021-2198).Ī 79-year-old female patient with no history of underlying diseases visited the clinic because of pitting edema in both lower legs. In the current publication, however, we report a patient who underwent transient lymphedema after COVID-19 vaccination with BNT16b2 and ChAdOx1 nCov-.19. Approximately 99% of these patients develop secondary lymphedema, which most often occurs after lymph node dissection following cancer resection. Once symptoms occur, it is very difficult to treat and can negatively affect the quality of life of patients. Lymphedema is a well-known disease entity that causes lymphatic fluid stasis, tissue fibrosis, and hypertrophic fat, resulting in skin ulceration and infections. However, complications from these vaccines have yet to be sufficiently analyzed because they are rapidly approved without long-term data. ![]() Efforts to lower the rate of infection entailed vaccination with COVID-19 vaccines such as BNT162b2 (Pfizer-BioNTech) or ChAdOx1 nCov-19 (AstraZeneca). Since the coronavirus disease 2019 (COVID-19) outbreak began in December 2019, approximately 220 million patients have been diagnosed to date, with an estimated 4.5 million deaths. ![]()
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