Dear Editor,
We would like to share ideas on the publication “Pituitary apoplexy and COVID-19 vaccination: correspondence”.1 Our manuscript emphasizes that, unfortunately, the vaccination could not be demonstrated as the cause of the apoplexy with certainty. However, following the WHO Assessment of causality of individual adverse events following immunization (AEFI) tool,2 we believe that this case meets the most relevant criteria: temporality and known causal association (VITT). The patient had no other classic risk factors for pituitary apoplexy: pregnancy, postpartum, trauma, hypertension, coagulopathy, recent surgery, or age in the 5–6th decade of life. She also did not present any concurrent incidences. Besides, our patient did not meet the epidemiological criteria for dengue3 nor did she present suspicious symptoms according to the Andalusian Dengue Surveillance Plan.4
Funding resources
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest
The authors declare no conflict of interests.
References
- 1.Mungmunpuntipantip R., Wiwanitkit V. Pituitary apoplexy and COVID-19 vaccination: correspondence. Med Clin. 2022 doi: 10.1016/j.medcli.2021.12.015. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Tozzi A.E., Asturias E.J., Balakrishnan M.R., Halsey N.A., Law B., Zuber P.L. Assessment of causality of individual adverse events following immunization (AEFI): a WHO tool for global use. Vaccine. 2013;31:5041–5046. doi: 10.1016/j.vaccine.2013.08.087. [DOI] [PubMed] [Google Scholar]
- 3.Monge S., García-Ortúzar V., López Hernández B., Lopaz Pérez M.Á., Delacour-Estrella S., Sánchez-Seco M.P., et al. Characterization of the first autochthonous dengue outbreak in Spain (August–September 2018) Acta Trop. 2020;205:10540–10542. doi: 10.1016/j.actatropica.2020.105402. [DOI] [PubMed] [Google Scholar]
- 4.Red Nacional de Vigilancia Epidemiológica. Protocolo de Vigilancia de Dengue; 2017. https://juntadeandalucia.es/export/drupaljda/salud_5af95879cc593_DENGUE_25082017.pdf [consulted 01.02.22].