COVID-19 vaccine-related immunological adverse event presented as reversible autoimmune disease with rheumatological feature and pulmonary infiltrates

Abstract

Rheumatological manifestation with acute febrile respiratory illness known to occur after coronavirus disease 2019 (COVID-19) pneumonia and presenting as long COVID disease, its occurrence with COVID vaccination is not very well associated or described in the literature. In this case report, a 45-year-old female presented with constitutional symptoms, persistent fever, and lung parenchymal infiltrates, without mycobacterial microscopic or genome documentation, received empirical antituberculosis (TB) treatment with the progression of disease with little clinical or radiological response. Bronchoscopy workup was inconclusive and tropical screen for bacterial, fungal, TB, and malignancy was negative. Vasculitis workup was inconclusive and rheumatological workup documented highly raised antinuclear antibodies titers. We have started her on steroid and hydroxychloroquine and clinical response documented with near-complete resolution of shadows in 12 weeks. Rheumatological syndrome which is a rare vaccine-related adverse event, reversible and easily treatable with routinely available medicines and importantly it is having excellent prognosis. Minimal systemic adverse events are known to occur with all viral vector vaccines, but its occurrence is rare and it should not impact on routine vaccinations as vaccination is a key step in this pandemic to protect humankind.

Keywords

• antinuclear antibodies test
• bronchoscopy
• coronavirus disease 2019 pneumonia
• febrile respiratory illness
• rheumatological syndrome