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ChAdOx1 nCoV-19疫苗接种后成人斯蒂尔病:一种可能的关联

Adult-onset Still's disease after ChAdOx1 nCoV-19 vaccine: a possible association.

作者信息

Albertino Laíssa Fiorotti, Moulaz Isac Ribeiro, Zogheib Tammer Ferreira, Valentim Martina Zanotti Carneiro, Machado Ketty Lysie Libardi Lira

机构信息

Universidade Federal do Espírito Santo (UFES), Medical School, Vitória, ES, Brasil.

Hospital Evangélico de Vila Velha, Department of Internal Medicine, Vila Velha, ES, Brasil.

出版信息

Autops Case Rep. 2022 Nov 7;12:e2021403. doi: 10.4322/acr.2021.403. eCollection 2022.

Abstract

With emergent Sars-Cov-2, a highly transmissive virus that caused millions of deaths worldwide, the development of vaccines became urgent to combat COVID-19. Although rare, important adverse effects had been described in a hypothetical scenario of immune system overstimulation or overreaction. Still's disease is a rare inflammatory syndrome of unknown etiology. It manifests as a cytokine storm, mainly IL-18 and IL-1β, and presents itself with fever spikes, joint pain, maculopapular evanescent salmon-pink skin rash, and sore throat, among other symptoms. Here, we report a case of a 44-year-old healthy male who developed adult-onset Still's disease (AOSD) with atypical symptoms after both doses of ChAdOx1 nCoV-19 vaccine with 3 months of dose interval. The medical team suspected Still's disease and started prednisone 1 mg/kg (40mg). The next day the patient showed a marked improvement in articular and chest pains and had no other fever episodes. Therefore, he was discharged to continue the treatment in outpatient care. On the six-month follow-up, the patient was free of complaints, and the progressive corticoid withdrawal plan was already finished.

摘要

随着新型严重急性呼吸综合征冠状病毒2(Sars-Cov-2)这种在全球导致数百万人死亡的高传播性病毒出现,开发疫苗以对抗新冠病毒病(COVID-19)变得刻不容缓。尽管罕见,但在免疫系统过度刺激或过度反应的假设情景中已描述过重要的不良反应。斯蒂尔病是一种病因不明的罕见炎症综合征。它表现为细胞因子风暴,主要是白细胞介素-18(IL-18)和白细胞介素-1β(IL-1β),并伴有高热、关节疼痛、一过性斑丘疹样鲑鱼粉红色皮疹和喉咙痛等症状。在此,我们报告一例44岁健康男性病例,该患者在间隔3个月接种两剂ChAdOx1 nCoV-19疫苗后出现非典型症状的成人斯蒂尔病(AOSD)。医疗团队怀疑为斯蒂尔病并开始使用泼尼松1毫克/千克(40毫克)。第二天,患者的关节和胸痛明显改善,且未再出现发热。因此,他出院继续门诊治疗。在六个月的随访中,患者无不适主诉,且已完成逐渐减少皮质类固醇用量的计划。

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