{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:53:38Z","timestamp":1789505618583,"version":"build-2803163510"},"reference-count":21,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>We report the case of a 19-year-old male who complained of myalgia, muscle weakness, and darkened urine two days after receiving his Ad26.COV2.S (Johnson &amp; Johnson, New Brunswick, New Jersey, United States) COVID-19 vaccination. Blood examination revealed an increased creatine kinase (CK) level, and his urinary dipstick tested positive for blood, indicative of acute rhabdomyolysis. Serum creatinine levels were normal. Rhabdomyolysis due to strenuous physical activity was ruled out and further diagnostics excluded an autoimmune cause. Under repeated treatment with intravenous fluid resuscitation (outpatient treatment), his symptoms resolved and peak CK levels of 44,180 U\/L returned to almost normal levels within two weeks. Rhabdomyolysis is a rare, potentially fatal vaccine-induced reaction. Further research is needed to better understand the underlying pathomechanism and to investigate whether subcutaneous injection of vaccines may be able to prevent rhabdomyolysis.<\/jats:p>","DOI":"10.3390\/vaccines9090956","type":"journal-article","created":{"date-parts":[[2021,8,31]],"date-time":"2021-08-31T22:58:15Z","timestamp":1630450695000},"page":"956","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Rhabdomyolysis Following Ad26.COV2.S COVID-19 Vaccination"],"prefix":"10.3390","volume":"9","author":[{"given":"Georg","family":"Gelbenegger","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6095-4899","authenticated-orcid":false,"given":"Filippo","family":"Cacioppo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christa","family":"Firbas","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5652-7977","authenticated-orcid":false,"given":"Bernd","family":"Jilma","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1056\/NEJMoa2104840","article-title":"Thrombotic Thrombocytopenia after ChAdOx1 nCov-19 Vaccination","volume":"384","author":"Greinacher","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1038\/s41541-020-00243-x","article-title":"Ad26 vector-based COVID-19 vaccine encoding a prefusion-stabilized SARS-CoV-2 Spike immunogen induces potent humoral and cellular immune responses","volume":"5","author":"Bos","year":"2020","journal-title":"NPJ Vaccines"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1824","DOI":"10.1056\/NEJMoa2034201","article-title":"Interim Results of a Phase 1\u20132a Trial of Ad26.COV2.S Covid-19 Vaccine","volume":"384","author":"Sadoff","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.1056\/NEJMoa2101544","article-title":"Safety and Efficacy of Single-Dose Ad26.COV2.S Vaccine against Covid-19","volume":"384","author":"Sadoff","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1056\/NEJMra0801327","article-title":"Rhabdomyolysis and Acute Kidney Injury","volume":"361","author":"Bosch","year":"2009","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ejim.2006.09.020","article-title":"The syndrome of rhabdomyolysis: Pathophysiology and diagnosis","volume":"18","author":"Giannoglou","year":"2007","journal-title":"Eur. J. Intern. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/S0140-6736(76)92781-1","article-title":"Mitochondrial Calcium Overload: A General Mechanism for Cell-Necrosis in Muscle Diseases","volume":"307","author":"Wrogemann","year":"1976","journal-title":"Lancet"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1681\/ASN.V1181553","article-title":"Rhabdomyolysis","volume":"11","author":"Vanholder","year":"2000","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1002\/mus.10053","article-title":"Rhabdomyolysis: A review","volume":"25","author":"Warren","year":"2002","journal-title":"Muscle Nerve"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s001340100878","article-title":"Pathogenesis and treatment of renal dysfunction in rhabdomyolysis","volume":"27","author":"Holt","year":"2001","journal-title":"Intensiv. Care Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1097\/01.md.0000188565.48918.41","article-title":"Rhabdomyolysis: An evaluation of 475 hospitalized patients","volume":"84","author":"Melli","year":"2005","journal-title":"Medicine"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1001\/archinte.1988.00380070059015","article-title":"Factors Predictive of Acute Renal Failure in Rhabdomyolysis","volume":"148","author":"Ward","year":"1988","journal-title":"Arch. Intern. Med."},{"key":"ref_13","first-page":"619","article-title":"Studies of mechanisms and protective maneuvers in myoglobinuric acute renal injury","volume":"60","author":"Zager","year":"1989","journal-title":"Lab. Investig."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1146\/annurev.me.33.020182.002251","article-title":"Rhabdomyolysis and Myoglobinuria","volume":"33","author":"Knochel","year":"1982","journal-title":"Annu. Rev. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"102170","DOI":"10.1016\/j.dsx.2021.06.007","article-title":"COVID-19 vaccine induced rhabdomyolysis: Case report with literature review","volume":"15","author":"Nassar","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Mack, M., Nichols, L., and Guerrero, D.M. (2021). Rhabdomyolysis Secondary to COVID-19 Vaccination. Cureus, 13.","DOI":"10.7759\/cureus.15004"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Tan, A., Stepien, K.M., and Narayana, S.T.K. (2021). Carnitine palmitoyltransferase II deficiency and post-COVID vaccination rhabdomyolysis. QJM Int. J. Med.","DOI":"10.1093\/qjmed\/hcab077"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.tmaid.2012.11.004","article-title":"Rhabdomyolysis secondary to influenza A H1N1 vaccine resulting in acute kidney injury","volume":"11","author":"Callado","year":"2013","journal-title":"Travel Med. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"861","DOI":"10.7326\/0003-4819-119-8-199310150-00024","article-title":"Tumor Necrosis Factor and Coxsackie B4 Rhabdomyolysis","volume":"119","author":"Konrad","year":"1993","journal-title":"Ann. Intern. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.3201\/eid2607.200445","article-title":"Rhabdomyolysis as Potential Late Complication Associated with COVID-19","volume":"26","author":"Jin","year":"2020","journal-title":"Emerg. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3087","DOI":"10.1007\/s11606-020-06039-y","article-title":"COVID-19 and Rhabdomyolysis","volume":"35","author":"Chedid","year":"2020","journal-title":"J. Gen. Intern. 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