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Vol. 19. Issue 2.
Pages 114-116 (February 2023)
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Vol. 19. Issue 2.
Pages 114-116 (February 2023)
Case report
Systemic lupus erythematosus myocarditis after COVID-19 vaccination
Miocarditis por lupus eritematoso sistémico después de la vacunación contra el COVID-19
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Miguel Sogbea,
Corresponding author
msogbe@unav.es

Corresponding author.
, Andrés Blanco-Di Matteoa, I. Madeleine Di Friscob, Juan Fernando Bastidasc, Nahikari Salteraind, Juan José Gavirad
a Internal Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain
b Pulmonary Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain
c Nuclear Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain
d Department of Cardiology, Clínica Universidad de Navarra, Pamplona, Spain
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Abstract
Introduction

Cases of acute myocarditis have been after administration of the BNT162b2 and Ad26.COV2.S vaccine.

Objective

Describe another possible mechanism of myocarditis after COVID-19 vaccination.

Case presentation

We describe the clinical case of a 72-year-old female with pleuritic chest pain one week after the third of the BNT162b2 mRNA vaccine. Serological tests for cardiotropic pathogens were negative, and autoimmunity screening was positive with anti-nuclear antibody (ANA) in 1:160 dilution, Anti-double-stranded DNA (anti-dsDNA), and anti-histone antibodies. 18F-fluoro-deoxy-glucose (FDG) positron emission tomography/computed tomography (PET/CT) showed a focal myocardial and pericardial inflammatory process in the cardiac apex.

Results and discussion

Systemic lupus erythematosus (SLE) diagnosis was made with myocardial affection. As far as we know, this is the first report of a case of lupus myocarditis after the COVID-19 vaccine.

Conclusion

Given the pathogenic rationales, the association between SLE and myocarditis should be considered.

Keywords:
Systemic lupus erythematosus
COVID-19 vaccination
BNT162B2 messenger RNA
Myocarditis
Resumen
Introducción

Se han presentado casos de miocarditis aguda tras la administración de las vacunas BNT162b2 y Ad26.COV2.S.

Objetivo

Describir otro posible mecanismo de miocarditis posterior a la vacunación contra el COVID-19.

Presentación del caso

Describimos el caso clínico de una mujer de 72 años con dolor torácico pleurítico una semana después de la tercera vacuna de ARNm BNT162b2. Las pruebas serológicas para patógenos cardiotrópos fueron negativas y el cribado de autoinmunidad fue positivo con anticuerpos antinucleares (ANA) en dilución 1:160, anticuerpos anti-ADN de doble cadena (anti-dsADN) y antihistonas. La tomografía por emisión de positrones/tomografía computarizada (PET/TC) con 18F-fluorodesoxiglucosa (FDG) mostró un proceso inflamatorio miocárdico y pericárdico focal en el ápex cardíaco.

Resultados y discusión

Se realizó el diagnóstico de lupus eritematoso sistémico (LES) con afectación miocárdica. Hasta donde sabemos, este es el primer reporte de un caso de miocarditis lúpica después de la vacuna contra el COVID-19.

Conclusión

Dadas las justificaciones patogénicas, se debe considerar la asociación entre lupus eritematoso sistémico (LES) y miocarditis.

Palabras clave:
Lupus eritematoso sistémico
Vacunación COVID-19
ARN mensajero BNT162B2
Miocarditis

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