コロナワクチン接種後に新規発症した関節リウマチの１例
近畿大医学部の報告
５３歳の日本人男性が、ファイザーの新型コロナワクチンを２回接種した。祖母が関節リウマチの家族歴がある。２回目接種後４週間後に左ひざ関節腫脹をきたした。その後直ちに肩痛と朝のこわばりが出現。CCP抗体、リウマチ因子が陽性。MRIの所見もあわせ、関節リウマチと診断された。
Case Report
A 53-year-old healthy Japanese man received BNT162b2 vaccination twice. His grandmother had RA. Successful immunization was verified by a marked elevation of anti-COVID-19-specific Ab titer (510 U/mL, normal range <15). Four weeks after the final vaccination, his left knee joint became swollen and painful. Soon after, he noticed bilateral omalgia and morning stiffness. Blood examination revealed marked leukocytosis (white blood cell, WBC count; 14,600/μL, normal range; 4,000~9,000) and elevated levels of C-reactive protein (CRP 8.45 mg/dL, normal range; 0~0.60). WBC counts and CRP levels were normal before the second vaccination (Figure 1A). His serum levels of anti-cyclic citrullinated peptide antibody and rheumatoid factor were 1,200 U/mL (normal range; 0~4.4) and 51 U/mL (normal range; 0~15), respectively. Magnetic resonance imaging showed diffuse knee effusion. Based on these typical symptoms and serological analyses, he was diagnosed as RA.