Presentation of SLE after COVID vaccination in a pediatric patient

• Type of Material: Article
• Authors: Meghan Corrigan Nelson, Emory University; Heather Rytting, Emory University; Larry Greenbaum, Emory University; Baruch Goldberg, Emory University
• Language: English
• Date: 2022-12-01
• Publisher: BioMed Central Ltd
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s41927-022-00313-8
• Title of Journal or Parent Work: BMC Rheumatology
• Volume: 6
• Issue: 1
• Start Page: 81
• End Page: 81
• Grant/Funding Information: No funding was obtained for this study.
• Keywords: Vaccination; Systemic lupus erythematosus; Lupus nephritis; Case report; SARS-CoV2; COVID-19
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Pathology

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.