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Case Reports
. 2022 Mar 2;15(3):e246533.
doi: 10.1136/bcr-2021-246533.

Marked increase of interferon-β after BNT162b2 mRNA vaccination: a case of polyarthritis with pleurisy

Hiroshi Shimagami  1 , Yuta Yamaguchi  1 , Yasuhiro Kato  2 , Atsushi Kumanogoh  1
Affiliations
Case Reports

Marked increase of interferon-β after BNT162b2 mRNA vaccination: a case of polyarthritis with pleurisy

Hiroshi Shimagami et al. BMJ Case Rep. .

Abstract

Exacerbation of rheumatic disease after vaccination against SARS-CoV-2 is being reported. However, there are only a few cases of new-onset rheumatic diseases. We present two cases of new-onset persistent polyarthritis that developed in patients after receiving the mRNA vaccine against SARS-CoV-2. One patient had bilateral pleural effusions with markedly elevated serum interferon (IFN)-β, while the other had no effusion, with serum IFN-β comparable with that in healthy subjects. Other cytokines were unaltered in association with effusion. Both patients responded well to treatment with 20 mg prednisolone. Although more investigations are needed, the marked increase in serum IFN-β levels observed in the case with pleural effusion may reflect an excessive response from the innate immune system to mRNA vaccines.

Keywords: COVID-19; immunological products and vaccines; immunology; musculoskeletal syndromes.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Pleural effusion after mRNA vaccination in case 1. Chest X-ray (A) and chest CT (B) showed bilateral pleural effusions.
Figure 2
Figure 2
Cytokine profile at the onset of adverse events associated with BNT162b2 vaccination. The graphs show serum cytokine levels of case 1, case 2, healthy subjects and patients with COVID-19, determined using a bead-based immunoassay (LEGENDplex Human Anti-Virus Response Panel (13-plex), BioLegend, San Diego, California, USA). In each panel, the values of healthy subjects and patients with COVID-19 indicate the median and the 75th percentile (upper) and 25th percentile (lower). IFN, interferon; IL, interleukin; TNF, tumour necrosis factor.
See this image and copyright information in PMC

References

    1. Barbhaiya M, Levine JM, Bykerk VP, et al. . Systemic rheumatic disease flares after SARS-CoV-2 vaccination among rheumatology outpatients in New York City. Ann Rheum Dis 2021;80:1352–4. 10.1136/annrheumdis-2021-220732 - DOI - PubMed
    1. Watad A, De Marco G, Mahajna H, et al. . Immune-mediated disease flares or new-onset disease in 27 subjects following mRNA/DNA SARS-CoV-2 vaccination. Vaccines 2021;9:435. 10.3390/vaccines9050435 - DOI - PMC - PubMed
    1. Quattrini L, Verardi L, Caldarola G, et al. . New onset of remitting seronegative symmetrical synovitis with pitting oedema and palmoplantar psoriasis flare-up after Sars-Cov-2 vaccination. J Eur Acad Dermatol Venereol 2021;35:e727–9. 10.1111/jdv.17502 - DOI - PMC - PubMed
    1. Aringer M, Costenbader K, Daikh D. European League against Rheumatism/American College of rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis 2019;2019:1151–9. - PubMed
    1. Aletaha D, Neogi T, Silma AJ. Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against rheumatism collaborative initiative. Ann Rheum Dis 2010;2010:1580–8. - PubMed

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