COVID-19 Vaccination as a Potential Trigger for New-Onset Systemic Lupus Erythematosus

Ikwinder Kaur; Saira Zafar; Eugenio Capitle; Reena Khianey

doi:10.7759/cureus.21917

COVID-19 Vaccination as a Potential Trigger for New-Onset Systemic Lupus Erythematosus

Cureus. 2022 Feb 4;14(2):e21917. doi: 10.7759/cureus.21917. eCollection 2022 Feb.

Authors

Ikwinder Kaur¹, Saira Zafar², Eugenio Capitle³, Reena Khianey³

Affiliations

¹ Internal Medicine, Monmouth Medical Center, Long Branch, USA.
² Allergy and Immunology, Rutgers University New Jersey Medical School, Newark, USA.
³ Rheumatology, Rutgers University New Jersey Medical School, Newark, USA.

Abstract

Immune hyperactivation has been linked to various vaccines. We present a potential association of new-onset systemic lupus erythematosus (SLE) post-COVID-19 immunization. The patient is a 54-year-old male admitted for evaluation of flu-like symptoms two weeks after receiving the second dose of the COVID-19 vaccine. Physical examination revealed high-grade fever, diffuse bilateral non-tender cervical lymphadenopathy, and erythematous maculopapular palpable purpuric lesions on bilateral feet. Laboratory evaluation showed a significant hypocomplementemia (C3 < 11 mg/dL, C4 < 3 mg/dL, and CH50 < 10 U/mL), high titer antinuclear antibody, anti-dsDNA antibodies, anti-Sjogren's syndrome-related antigen A antibodies, anti-Sjogren's syndrome-related antigen B antibodies, anti-Smith antibodies, anti-ribonucleoprotein antibodies, anti-histone antibodies with a negative malignancy, and infection workup. The patient was treated with a high dose of steroids with a positive response. This case highlights the possibility of SLE, a rare adverse event following COVID-19 vaccination.

Keywords: autoimmunity; covid-19; covid-19 vaccination; immunization; systemic lupus erythematosus.

Publication types

Case Reports