Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Japan.
Intern Med. 2022 Mar 15;61(6):903-906. doi: 10.2169/internalmedicine.8829-21. Epub 2021 Dec 28.
Polymyalgia rheumatica (PMR) is an inflammatory rheumatic disease characterized by stiffness and aching mainly in the shoulders, neck and hip girdles. The underlying pathogenesis of PMR involves myeloid lineage activation with a high expression of pattern recognition receptors. In addition, vaccination against severe acute respiratory syndrome coronavirus 2 with mRNA-1273 functions as both an immunogen and intrinsic adjuvant. It leads to the activation of innate immunity, resulting in antibody production. We herein report the first case of PMR-like syndrome seven days after mRNA-1273 vaccination. Reassuringly, the symptoms, such as pain of the neck, shoulder girdle and pelvic girdle, as well as elevated inflammatory markers were resolved within a month without glucocorticoid or immunosuppressant administration.
巨细胞动脉炎(PMR)是一种炎症性风湿性疾病,主要表现为肩部、颈部和髋部的僵硬和疼痛。PMR 的潜在发病机制涉及髓系细胞的激活,伴有模式识别受体的高表达。此外,mRNA-1273 对严重急性呼吸综合征冠状病毒 2 的疫苗接种既具有免疫原性,又具有内在佐剂作用。它导致先天免疫的激活,从而产生抗体。本文报告首例 mRNA-1273 接种后 7 天出现 PMR 样综合征。令人欣慰的是,颈部、肩部和髋部疼痛以及炎症标志物升高的症状在一个月内无需糖皮质激素或免疫抑制剂治疗即可缓解。