Department of Medicine I, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, Jena, 07747, Germany.
MVZ für Klinische Pathologie, Klinikum Darmstadt GmbH, Darmstadt, Germany.
ESC Heart Fail. 2021 Dec;8(6):4710-4714. doi: 10.1002/ehf2.13613. Epub 2021 Sep 18.
We describe a case of a 20-year-old healthy man developing chest pain and classical symptoms of vaccine reactogenicity 12 h after receiving the first dose of mRNA-1273 (Moderna). Cardiac troponin T was increased, and subepicardial inflammation and focal contractile dysfunction were detected by cardiac magnetic resonance imaging and echocardiography. We confirmed the diagnosis of acute myocarditis by endomyocardial biopsy demonstrating significant infiltration of monocytes and T lymphocytes. Although we detected IgG against nucleocapsid protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) indicating prior infection, the patient repeatedly tested negative for SARS-CoV-2 and had been asymptomatic for several months. Furthermore, viral genome analysis of endomyocardial biopsy samples was negative for SARS-CoV-2 and other potential cardiotropic viruses. These findings and the strong temporal relation between the vaccination and the symptom onset imply a potential side effect of mRNA-1273.
我们描述了一例 20 岁健康男性在接种 Moderna 公司的 mRNA-1273 疫苗第一针 12 小时后出现胸痛和典型的疫苗不良反应症状。心肌肌钙蛋白 T 升高，心脏磁共振成像和超声心动图检查发现心外膜下炎症和局灶性收缩功能障碍。通过心内膜心肌活检证实了急性心肌炎的诊断，活检显示单核细胞和 T 淋巴细胞明显浸润。尽管我们检测到针对严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）核衣壳蛋白的 IgG，表明之前感染过，但患者反复 SARS-CoV-2 检测均为阴性，且已无症状数月。此外，心内膜心肌活检样本的病毒基因组分析也排除了 SARS-CoV-2 和其他潜在的心脏嗜性病毒。这些发现以及疫苗接种和症状出现之间的强烈时间关系提示 mRNA-1273 可能存在潜在的副作用。
