Clinical and Molecular Characterization of a Rare Case of BNT162b2 mRNA COVID-19 Vaccine-Associated Myositis
Eli Magen,
Sumit Mukherjee,
Mahua Bhattacharya,
Rajesh Detroja,
Eugene Merzon,
Idan Blum,
Alejandro Livoff,
Mark Shlapobersky,
Gideon Baum,
Ran Talisman,
Evgenia Cherniavsky,
Amir Dori,
Milana Frenkel-Morgenstern
Affiliations
Eli Magen
Medicine C Department, Clinical Immunology and Allergy Division, Barzilai University Medical Center, Ben-Gurion University of the Negev, Ashkelon 7830604, Israel
Sumit Mukherjee
Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
Mahua Bhattacharya
Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
Rajesh Detroja
Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
Eugene Merzon
Leumit Health Services, Tel Aviv 6473817, Israel
Idan Blum
Medicine C Department, Clinical Immunology and Allergy Division, Barzilai University Medical Center, Ben-Gurion University of the Negev, Ashkelon 7830604, Israel
Alejandro Livoff
Pathology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel
Mark Shlapobersky
Pathology Department, Barzilai University Medical Center, Ashkelon 7830604, Israel
Gideon Baum
Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
Ran Talisman
Plastic Surgery Department, Barzilai University Medical Center, Ashkelon 7830604, Israel
Evgenia Cherniavsky
Imaging Department, Barzilai University Medical Center, Ashkelon 7830604, Israel
Amir Dori
Department of Neurology, Sheba Medical Center, Ramat Gan 5262000, Israel
Milana Frenkel-Morgenstern
Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
Initial clinical trials and surveillance data have shown that the most commonly administered BNT162b2 COVID-19 mRNA vaccine is effective and safe. However, several cases of mRNA vaccine-induced mild to moderate adverse events were recently reported. Here, we report a rare case of myositis after injection of the first dose of BNT162b2 COVID-19 mRNA vaccine into the left deltoid muscle of a 34-year-old, previously healthy woman who presented progressive proximal muscle weakness, progressive dysphagia, and dyspnea with respiratory failure. One month after vaccination, BNT162b2 vaccine mRNA expression was detected in a tissue biopsy of the right deltoid and quadriceps muscles. We propose this case as a rare example of COVID-19 mRNA vaccine-induced myositis. This study comprehensively characterizes the clinical and molecular features of BNT162b2 mRNA vaccine-associated myositis in which the patient was severely affected.
