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BMC Rheumatol . Presentation of SLE after COVID vaccination in a pediatric patient

tetano

Editor, Senior Moderator
BMC Rheumatol


. 2022 Dec 20;6(1):81.
doi: 10.1186/s41927-022-00313-8.
Presentation of SLE after COVID vaccination in a pediatric patient


Meghan Corrigan Nelson[SUP] 1 2 [/SUP], Heather Rytting[SUP] 3 [/SUP], Larry A Greenbaum[SUP] 4 5 [/SUP], Baruch Goldberg[SUP] 6 4 [/SUP]



Affiliations

Abstract

Background: The outbreak of severe acute respiratory syndrome coronavirus 2 has had an enormous impact on global health. Vaccination remains one of the most effective interventions for disease prevention. Clinically significant vaccine side effects are uncommon, though autoimmune-mediated disease occurs in a small percentage of vaccine recipients. Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that is associated with significant morbidity and mortality. Childhood-onset SLE tends to have more severe disease manifestations than adult-onset SLE. In adults, there are a few reported cases of SLE developing soon after coronavirus disease 2019 (COVID-19) mRNA vaccination.
Case presentation: A 14-year-old previously healthy male developed laboratory and clinical evidence of SLE, including maculopapular malar rash, arthritis, pleuritic chest pain, and class V (membranous) lupus nephritis, 2 days after his third dose of the Pfizer-BioNTech COVID-19 vaccine. The patient's symptoms improved after initiation of prednisone and mycophenolate mofetil. We also summarize eleven prior case reports describing SLE after COVID-19 vaccine in adults.
Conclusion: To our knowledge, this is the first reported pediatric patient with new onset SLE following COVID-19 mRNA vaccination. While potential mechanistic links exist between COVID-19 vaccination and SLE development, additional studies are necessary to elucidate the exact nature of this relationship.

Keywords: COVID-19; Case report; Lupus nephritis; SARS-CoV2; Systemic lupus erythematosus; Vaccination.
 
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