Torrealba-Acosta Gabriel, Martin Jennifer C, Huttenbach Yve, Garcia Catherine R, Sohail Muhammad R, Agarwal Sandeep Krishna, Wasko Carina, Bershad Eric M, Hirzallah Mohammad I
Neurology, Baylor College of Medicine, Houston, Texas, USA
Department of Dermatology, Baylor College of Medicine, Houston, Texas, USA.
BMJ Case Rep. 2021 Jul 26;14(7):e243173. doi: 10.1136/bcr-2021-243173.
A patient presented with fever, generalised rash, confusion, orofacial movements and myoclonus after receiving the first dose of mRNA-1273 vaccine from Moderna. MRI was unremarkable while cerebrospinal fluid showed leucocytosis with lymphocyte predominance and hyperproteinorrachia. The skin evidenced red, non-scaly, oedematous papules coalescing into plaques with scattered non-follicular pustules. Skin biopsy was consistent with a neutrophilic dermatosis. The patient fulfilled the criteria for Sweet syndrome. A thorough evaluation ruled out alternative infectious, autoimmune or malignant aetiologies, and all manifestations resolved with glucocorticoids. While we cannot prove causality, there was a temporal correlation between the vaccination and the clinical findings.
一名患者在接种第一剂Moderna公司的mRNA-1273疫苗后，出现发热、全身性皮疹、意识模糊、口面部运动及肌阵挛。磁共振成像（MRI）无明显异常，而脑脊液显示白细胞增多，以淋巴细胞为主，且蛋白含量增高。皮肤表现为红色、无鳞屑、水肿性丘疹，融合成斑块，并伴有散在的非毛囊性脓疱。皮肤活检符合嗜中性皮肤病。该患者符合Sweet综合征的诊断标准。全面评估排除了其他感染性、自身免疫性或恶性病因，所有症状在使用糖皮质激素后均得到缓解。虽然我们无法证明因果关系，但疫苗接种与临床症状之间存在时间上的关联。
