• Medicine · Jun 2023

    Review Case Reports

    Development of giant cell arteritis after vaccination against SARS-CoV2: A case report and literature review.

    • Hiroki Wakabayashi, Misa Iwayanagi, Daiki Sakai, Yoshiya Sugiura, Nobuyuki Hiruta, Yasuo Matsuzawa, and Kaichi Kaneko.
    • Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan.
    • Medicine (Baltimore). 2023 Jun 2; 102 (22): e33948e33948.

    RationaleGiant cell arteritis (GCA) is an autoimmune vasculitis that affects large and medium-sized blood vessels. The mRNA vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has been associated with the development of immune-mediated diseases. In this article, we present a case of GCA that developed after vaccination against SARS-CoV2.Patient ConcernsA 77-year-old man developed fever, general fatigue, and headache 1 day after the third dose of vaccination against SARS-CoV2. Nodular swelling and tenderness of the bilateral temporal arteries were observed.DiagnosesAlthough right temporal artery biopsies were negative, the patient was diagnosed with GCA based on criteria established by the American College of Rheumatology for the classification of GCA.InterventionsThe patient received methylprednisolone 1000 mg for 3 days. This was followed by prednisolone 1 mg/kg/d, which was decreased by 10 mg every week to 30 mg. From day 16 of hospitalization, the patient received tocilizumab 162 mg/wk every other week.OutcomesThere was no occurrence of acute side effects. After 38 days of treatment, the condition improved and the patient was discharged from the hospital; as stated above, the dose of prednisolone was tapered to 30 mg/d.LessonsWe experienced a case of GCA that occurred immediately after vaccination against SARS-CoV2 with an mRNA vaccine. Early signs of GCA include fever, fatigue, and headache, and often resemble those noted after vaccination against SARS-CoV2. The potential presence of GCA should be determined in individuals with persistent fever and headache after vaccination against SARS-CoV2.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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