Komori Yuta, Kobayashi Satomi, Hatano Keiko, Saito Yuko, Arai Tomio, Kubo Kanae
Department of Medicine and Rheumatology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Department of Neurology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.
Mod Rheumatol Case Rep. 2025 Jan 16;9(1):104-109. doi: 10.1093/mrcr/rxae055.
As vaccination against SARS-CoV-2 has progressed, various autoimmune diseases, including inflammatory myopathies, have been reported to develop after vaccination. Sjögren's syndrome (SS) sometimes presents as extra-glandular manifestations including inflammatory myopathy. In this report, we describe a case of inflammatory myopathy associated with SS that occurred in an atypically elderly patient after receiving the first dose of the SARS-CoV-2 mRNA vaccine (BNT162b2). The inflammatory myopathy was pathologically classified into non-specific myositis and characterised by predominant infiltration of the B cell lineage in this case. Combined treatment with glucocorticoid, intravenous immunoglobulin, and immunosuppressant resulted in an improvement in swallowing function and muscle strength. While we recognise the efficacy and safety of SARS-CoV-2 vaccines, we also emphasise the importance of recognising that individuals with an immunogenetic predisposition such as positivity of anti SS-A antibody may show disease activity including inflammatory myopathy following vaccination in SS, even at an atypically old age.
随着针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的疫苗接种工作推进，包括炎性肌病在内的各种自身免疫性疾病被报道在接种疫苗后发生。干燥综合征（SS）有时会表现为包括炎性肌病在内的腺外表现。在本报告中，我们描述了一例在一名非典型老年患者接种第一剂SARS-CoV-2信使核糖核酸疫苗（BNT162b2）后发生的与SS相关的炎性肌病病例。该炎性肌病在病理上被归类为非特异性肌炎，在本病例中其特征为B细胞谱系的大量浸润。糖皮质激素、静脉注射免疫球蛋白和免疫抑制剂的联合治疗使吞咽功能和肌肉力量得到改善。虽然我们认可SARS-CoV-2疫苗的有效性和安全性，但我们也强调认识到具有免疫遗传易感性的个体（如抗SS-A抗体阳性）在SS中接种疫苗后可能出现包括炎性肌病在内的疾病活动的重要性，即使是在非典型老年时。
