• Takuma Tsuzuki Wada, Kazuhiro Yokota, Fumito Inayoshi, Sakon Sakai, Nobuhito Okumura, Mayumi Matsuda, Iichiro Osawa, Yasuto Araki, Funakubo AsanumaYuYDepartment of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Japan., Yuji Akiyama, and Toshihide Mimura.
• Department of Rheumatology and Applied Immunology, Faculty of Medicine, Saitama Medical University, Japan.
• Intern. Med. 2023 Dec 15; 62 (24): 369937063699-3706.

AbstractWe present the case of a 42-year-old woman with rheumatoid arthritis and Sjögren's syndrome treated with adalimumab who developed immune-mediated necrotizing myopathy (IMNM) and trigeminal neuropathy after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccination. Trigeminal neuralgia and elevated serum creatine kinase levels emerged 12 days post-vaccination, followed by myalgia in the femoral muscles. IMNM was histologically diagnosed. The pathogenesis may involve molecular mimicry between the SARS-CoV-2 spike glycoprotein and autologous tissues triggered by vaccination. This case emphasizes the association between SARS-CoV-2 vaccination, tumor necrosis factor inhibitor, IMNM, and trigeminal neuropathy, as well as the importance of monitoring immune-mediated adverse events following SARS-CoV-2 vaccination in patients with autoimmune disease.

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