Mixed Connective Tissue Disease Onset in the Setting of COVID Vaccination - Case Report and Recommendations

Main Article Content

Akber Sheikh
Asim Godil
Diem Pham
Suha Godil

Keywords

autoimmune reaction, mixed connective tissue disease, mctd, scleroderma, systemic sclerosis, dermatomyositis, myositis, lupus, subacute cutaneous lupus erythematosus, vaccine eruption, vaccine reaction, covid-19, covid-19 vaccine

Abstract

Background: As of 2024, the COVID-19 pandemic has infected over 700 million people resulting in over 7 million deaths worldwide. The vaccination has had significant controversy, partially implicated through a number of reported adverse events. Previous studies have suggested that vaccines can trigger autoimmune disease and the COVID-19 vaccine has been no exception to this. This study presents a case report and literature review exploring the potential link between the COVID-19 vaccination and autoimmune reactions.


Case Report: We present a previously healthy 28 year old male who developed a diffuse pruritic rash two weeks after receiving a booster Moderna vaccine for COVID-19. The patient, with a history of hypothyroidism and positive antinuclear antibody (ANA), exhibited pink erythematous, minimally scaly papules and plaques, predominantly on his hands, forearms, wrists, face, neck, and left shoulder. Subsequent workup revealed elevated anti-ribonucleoprotein (RNP) levels, leading to a diagnosis of mixed connective tissue disease (MCTD). This paper also features a review on cutaneous and systemic autoimmune conditions thought to be triggered by COVID-19 vaccines. Potential mechanisms are explored including molecular mimicry, bystander activation, and epitope spreading. Findings indicate that cutaneous reactions like dermatitis, urticaria, and morbilliform rashes are relatively common and can predispose more severe autoimmune conditions.


Conclusion: Implications of this study are the importance for medical professionals and patients to be wary of autoimmune reactions post-vaccination. Early recognition and management of these reactions is critical in ensuring patient safety, improving vaccination protocols, and maintaining public trust in vaccination programs and efforts.

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