Abstract
With the global spread of severe acute respiratory syndrome coronavirus 2, several vaccines were developed; messenger RNA (mRNA) vaccines have recently been widely used worldwide. However, the incidence of myocarditis following mRNA vaccination is increasing; although the cause of myocarditis has not yet been clearly identified, it is presumed to be caused by a problem in the innate immune system. Immune-mediated thrombocytopenia (ITP) after vaccination is rare but has been reported and is also assumed to occur by the same mechanism. We report the first case of simultaneous myocarditis and ITP after mRNA vaccination. A 38-year-old woman presented with chest pain, mild dyspnea, and sweating after vaccination with mRNA-1273 vaccine (Moderna) 4 days prior to admission. Upon admission to the emergency department, cardiac enzymes were elevated; blood test performed 5 months ago showed normal platelet count, but severe thrombocytopenia was observed upon admission. After administration of intravenous immunoglobulin, the platelet count improved; subsequently, myocarditis was observed on endomyocardial biopsy. Thus, myocarditis and ITP were judged to have occurred simultaneously due to the expression of the innate immune system markers after mRNA vaccination. The patient was discharged on day 6 of admission.
Keywords: COVID-19; Myocarditis; Thrombocytopenia; Vaccination.
【저자키워드】 COVID-19, vaccination, myocarditis, thrombocytopenia, 【초록키워드】 mRNA vaccination, Intravenous immunoglobulin, Vaccine, coronavirus, vaccination, mRNA-1273, severe acute respiratory syndrome Coronavirus, emergency department, innate immune system, Spread, Endomyocardial biopsy, Immunoglobulin, myocarditis, mRNA, Dyspnea, Patient, Platelet, Mild, thrombocytopenia, incidence, expression, Admission, mechanism, Blood, Moderna, blood test, Platelet count, marker, administration, chest pain, Messenger RNA, mRNA-1273 vaccine, acute respiratory syndrome, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, problem, cardiac enzymes, sweating, performed, occurred, caused, reported, occur, discharged, assumed, cardiac enzyme, 【제목키워드】 Simultaneous, report,