Camargo Coronel Adolfo, Jiménez Balderas Francisco Javier, Quiñones Moya Horacio, Hernández Zavala Mario Raúl, Mandinabeitia Rodríguez Pedro, Hernández Vázquez José Ramiro, Zamora Zarco Sandy, Aguilar Castillo Sergio De Jesús
Rheumatology Department, "Centro Medico Nacional Siglo XXI", Mexico City, Mexico.
BMC Rheumatol. 2022 Apr 1;6(1):20. doi: 10.1186/s41927-022-00250-6.
Dermatomyositis belongs to an infrequent group of diseases predominantly found in patients older than 40 years old and is characterized by dermal and muscular findings. This disease presents itself as proximal, ascending and symmetric weakness and typical dermatosis with findings such as elevated muscle enzymes, altered electromyography and typical changes in muscle biopsy; as of today, the etiology of the disease in unknown. The COVID-19 vaccine has been a fundamental tactic to achieve control of the coronavirus (SARS CoV2), and it's clear that the benefits of getting the vaccine overweight the risks that might come along with it. Although rare, all adverse effects should be reported, this could help us to understand the elusive pathophysiology of inflammatory idiopathic myopathy.
In this text we will describe the case of a patient with dermatomyositis who was vaccinated against SARS CoV2 with BNT162b2 mRNA (Pfizer-BioNTech), showing a temporal relation between the vaccination and the beginning of her symptoms. We realized all the diagnostic approach to the suspected disease including electromyography, muscle biopsy and laboratory findings, corroborating the diagnosis. The patient received standard treatment for this disease (steroid therapy) and have a classic slow improvement.
Although it´s not possible to confirm a direct correlation between the vaccine and the onset of the disease, we considered that there are enough data to suspect that this could be a trigger event and therefore should always be considered a possible cause for a case of inflammatory idiopathic myopathy.
皮肌炎属于一组罕见疾病,主要见于40岁以上患者,其特征为皮肤和肌肉表现。该病表现为近端、进行性和对称性肌无力以及典型的皮肤病,伴有肌酶升高、肌电图改变和肌肉活检的典型变化;迄今为止,该病的病因尚不清楚。新冠疫苗一直是控制冠状病毒(SARS-CoV-2)的一项基本策略,显然接种疫苗的益处大于可能伴随而来的风险。尽管罕见,但所有不良反应都应报告,这有助于我们了解炎症性特发性肌病难以捉摸的病理生理学。
在本文中,我们将描述一名皮肌炎患者的病例,该患者接种了BNT162b2 mRNA(辉瑞-生物科技公司)新冠疫苗,显示出接种疫苗与症状开始之间存在时间关联。我们采用了针对疑似疾病的所有诊断方法,包括肌电图、肌肉活检和实验室检查结果,证实了诊断。该患者接受了该病的标准治疗(类固醇疗法),病情有典型的缓慢改善。
虽然无法证实疫苗与疾病发作之间存在直接关联,但我们认为有足够的数据怀疑这可能是一个触发事件,因此应始终将其视为炎症性特发性肌病病例的一个可能原因。