Recurrent mRNA (BNT162b2) Covid-19 Vaccine-Associated Pericarditis in an Elderly Man with Multiple Comorbidities

Angel Goenawan^1, , Frank Kussaga¹, Kenneth Schwartz² and Seema D’Souza¹

¹Department of Internal Medicine, Griffin Hospital, Derby, CT

²Department of Cardiology, Griffin Hospital, Derby, CT

Cite this paper

Angel Goenawan, Frank Kussaga, Kenneth Schwartz and Seema D’Souza. Recurrent mRNA (BNT162b2) Covid-19 Vaccine-Associated Pericarditis in an Elderly Man with Multiple Comorbidities. American Journal of Medical Case Reports. 2021; 9(12):709-713. doi: 10.12691/AJMCR-9-12-12

Abstract

Myocarditis and pericarditis are known adverse effects from mRNA Covid-19 vaccines and are seen in young men usually after the second dose of vaccine. We report a case of recurrent pericarditis in a 67 year old man with history of diabetes and chronic kidney disease that occured with both vaccine doses, with the second episode associated with interval development of small pericardial effusion and moderate pleural effusion. Patient did not seem to have concomitant myocarditis as he did not have any troponin leak. He was managed with colchicine and prednisone with resultant improvement of his inflammatory markers on follow up.

Keywords

pericarditis, Covid-19 vaccine, recurrent pericarditis, pericardial effusion

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Covid-19 Vaccines; Food and Drug Administration resources page; https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines; updated July 20, 2021; accessed July 27, 2021.
[2]	Wrapp D, Wang NS, Corbett KS, Goldsmith JA, Hsieh CL, Abiona O, Graham BS, McLellan JS. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. Mar 13, 2020; 367(6483): 1260-3.
[3]	Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, Perez JL, Marc GP, Moreira ED, Zerbini C, Bailey R, Swanson KA, Roychoudhury S, Koury K, Li P, et al. Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine. N Engl J Med. 2020; 383: 2603-15.
[4]	Myocarditis and Pericarditis Following mRNA Covid-19 Vaccination. CDC; https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html; updated June 23, 2021. Accessed July 27, 2021.
[5]	Ammirati E, Cavalotti C, Milazzo A, Pedrotti P, Soriano F, Schroeder JW, Morici N, Giannattasio C, Frigerio M, Metra M, Camici PG, Olivia F. Temporal Relation Between Second Dose BNT162b2 mRNA Covid-19 Vaccine and Cardiac Involvement in a Patient with Previous SARS-CoV-2 Infection. Int J Cardiol Heart Vasc. 2021 Jun; 100774.
[6]	Segal Y, Shoenfeld Y. Vaccine-induced Autoimmunity: the Role of Molecular Mimicry and Immune Crossreaction. Cell Mol Immunol. 2018 Jun; 15(6): 586-94