Simultaneous Occurrence of Immune-Mediated Thrombocytopenia and Myocarditis After mRNA-1273 COVID-19 Vaccination: A Case Report

Bae Dae-Hwan; Kim Min; Lee Dae In; Lee Ju-Hee; Kim Sangmin; Lee Sang Yeub; Bae Jang-Whan; Hwang Kyung-Kuk; Kim Dong-Woon; Cho Myeong-Chan

doi:10.3346/jkms.2022.37.e169

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자료유형: 학술저널

저자정보: Bae Dae-Hwan (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.) Kim Min (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.) Lee Dae In (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.) Lee Ju-Hee (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.) Kim Sangmin (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.) Lee Sang Yeub (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.) Bae Jang-Whan (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.Divisio) Hwang Kyung-Kuk (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.Divisio) Kim Dong-Woon (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.Divisio) Cho Myeong-Chan (Regional Cardiovascular Disease Center Chungbuk National University Hospital Cheongju Korea.Divisio)

저널정보: 대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.37 No.21

발행연도: 2022.5

수록면: 1 - 5 (5page)

DOI: 10.3346/jkms.2022.37.e169

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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.

#Thrombocytopenia #Myocarditis #COVID-19 #Vaccination

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