Sugimoto Tomohiro, Yorishima Ai, Oka Naoya, Masuda Sho, Nakamoto Naoki, Kidoguchi Genki, Watanabe Hirofumi, Yoshida Yusuke, Mokuda Sho, Hirata Shintaro
Hiroshima University Hospital, Department of Clinical Immunology and Rheumatology, Hiroshima, Japan.
Department of Rheumatology, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Mod Rheumatol Case Rep. 2023 Jan 3;7(1):108-112. doi: 10.1093/mrcr/rxac064.
The direct causes of dermatomyositis, a common autoimmune disease, have not yet been accurately identified, but several studies have linked this condition to various patient-associated and environmental factors, such as viral infections and area of residence. In the present report, we describe our experience with a patient presenting with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis, which developed after vaccination against coronavirus disease 2019 (COVID-19). This patient was simultaneously diagnosed with anti-glutamic acid decarboxylase antibody-positive slowly progressive insulin-dependent diabetes (SPIDDM); her human leucocyte antigen test revealed that she expressed the DRB1*04:05 allele. This is important as this genotype is known to increase susceptibility to both anti-MDA5 antibody-positive dermatomyositis and type I diabetes. To the best of our knowledge, this is the first case of dermatomyositis complicated by SPIDDM identified after COVID-19 vaccination against COVID-19 and presenting with an underlying susceptible genotype. The patient's genetic predisposition may also be important for the development of autoimmune disease after COVID-19 vaccination.
皮肌炎是一种常见的自身免疫性疾病，其直接病因尚未得到准确识别，但多项研究已将这种疾病与各种患者相关因素和环境因素联系起来，如病毒感染和居住地区。在本报告中，我们描述了一位患有抗黑色素瘤分化相关基因5（MDA5）抗体阳性皮肌炎患者的情况，该疾病在接种2019冠状病毒病（COVID-19）疫苗后出现。该患者同时被诊断为抗谷氨酸脱羧酶抗体阳性的缓慢进展性胰岛素依赖型糖尿病（SPIDDM）；她的人类白细胞抗原检测显示她表达了DRB1*04:05等位基因。这一点很重要，因为已知这种基因型会增加患抗MDA5抗体阳性皮肌炎和I型糖尿病的易感性。据我们所知，这是首例在接种COVID-19疫苗后确诊的并发SPIDDM的皮肌炎病例，且存在潜在的易感基因型。患者的遗传易感性对于COVID-19疫苗接种后自身免疫性疾病的发生可能也很重要。
