Systemic lupus erythematosus in a 36-year old Filipino male after SARS-COV- 2 vaccination
International Journal of Rheumatic Diseases
; 26(Supplement 1):160.0, 2023.
Article
in English
| EMBASE | ID: covidwho-2230574
ABSTRACT
Background:
Systemic lupus erythematosus (SLE), a multisystem autoimmune disease more common in females, is associated with autoantibodies against different autoantigens forming immune complexes. Inadequate removal of these complexes from the host triggers inflammatory response which causes tissue damage. Some antiviral vaccines have been associated with the onset of SLE. Few cases of SLE occurring after SARS-CoV- 2 vaccines have been reported. Herein, we describe a case of new-onset SLE associated with COVID-19 vaccine. CaseSummary:
A previously well 36-year- old male with unremarkable family history of autoimmune disease started to develop muscle and joint pains, hair thinning, and ecchymoses 2 months after receiving second dose of inactivated SARS-CoV- 2 vaccine. He was subsequently admitted after consultation due to thrombocytopenia (platelet count of 58). He was given high dose steroid with tapering dose during the entire 14 days admission with significant increase of platelet count after 72 hours of repeat complete blood count. He went consult at rheumatology clinic a month after due to persistent joint and muscle pains, and progression of hair fall with associated facial rash, oral ulcers, easy fatigability and weight loss. Physical exam disclosed an ambulatory well-built male with normal vital signs, alopecia, malar rash, oral ulcers, joint tenderness and no objective muscle weakness. Complete blood counts and Anti-smith were within normal. Urinalysis, Antinuclear antibody (ANA), Anti-SSA, Anti-SSB, complement factor 3 (C3), and Anti-dsDNA were positive. He was managed with tapering prednisone and hydroxychloroquine with significant improvement at time of this report. Conclusion(s) Development of autoimmune reaction following COVID-19 vaccine has been described extensively;however, evidence of autoimmunity following vaccination seems to be lacking at present. Pathomechanisms include defective elimination and/or control of self-reactive lymphocytes resulting in over-stimulation of the immune system leading to clinical manifestations strikingly similar to the infection itself. Management approach to these autoimmune reactions address the immune hyper-stimulation with immunosuppressive or immuno-modulating agents including steroids and hydroxychloroquine.
adult; adverse drug reaction; alopecia; arthralgia; autoimmune disease; autoimmunity; blood cell count; body weight loss; case report; clinical article; conference abstract; consultation; drug megadose; drug therapy; ecchymosis; face rash; family history; Filipino (citizen); hair; human; human cell; immunostimulation; lymphocyte; malar rash; male; mouth ulcer; muscle weakness; myalgia; nonhuman; physical examination; platelet count; rheumatology; Severe acute respiratory syndrome coronavirus 2; side effect; systemic lupus erythematosus; thrombocytopenia; urinalysis; vaccination; vital sign; antinuclear antibody; complement component C3; endogenous compound; hydroxychloroquine; prednisone; SARS-CoV-2 vaccine; Sm antibody
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Observational study
/
Prognostic study
Topics:
Vaccines
Language:
English
Journal:
International Journal of Rheumatic Diseases
Year:
2023
Document Type:
Article
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