Sex: M
Vaccine: COVID19
Symptoms: Autopsy, Body mass index, Gene sequencing, Investigation, Microscopy
Clinical narrative: Myocarditis; This is a literature report.   An adolescent male patient received bnt162b2 (BNT162B2) (Batch/Lot number: unknown) as dose 2, single for covid-19 immunisation. Relevant medical history included: "attention deficit hyperactivity disorder" (unspecified if ongoing). The patient's concomitant medications were not reported. Past drug history included: Amphetamine for attention deficit hyperactivity disorder; Dextroamphetamine for attention deficit hyperactivity disorder. Vaccination history included: Covid-19 vaccine (DOSE 1; MANUFACTUERER UNKNOWN), for COVID-19 immunisation. The following information was reported: MYOCARDITIS (death), outcome "fatal", described as "Myocarditis". The patient underwent the following laboratory tests and procedures: autopsy: microscopic myocardial findings, notes: There was global myocardial injury with areas of coagulative myocytolysis and contraction bands, with a perivascular pattern of inflammation consisting of predominantly neutrophils with histiocytes, scant lymphocytes, and occasional eosinophils; body mass index: 21; gene sequencing: detected two variants of uncertain significance:, notes: DOLK  (c.1257C>G (p.Ile419Met) heterozygous) and  MAP2K2 (c.581 - 3C>T (Intronic) heterozygous); investigation: in some sections, the myocardial injury was, notes: predominantly subepicardial, while in other sections it was patchy and transmural. In the posterior wall, there was subepicardial/transmural fibrous scar, without fatty replacement. There were no acute or organizing thrombi. The overall pattern of injury was consistent with "stress cardiomyopathy" with contraction bands and a neutrophilic/histiocytic infiltrate; investigation: 280 g, notes: normal; microscopy: microscopic findings are not the alterations seen, notes: with typical myocarditis. This suggest a role for cytokine storm which may occur with an excessive inflammatory response, as there also is a feedback loop between catecholamines and cytokines; sars-cov-2 test: pcr tissue testing performed by the cdc on heart, notes: and lung found no molecular evidence of SARS-CoV-2 infection; toxicologic test: negative for medications and drugs of abuse. The patient date of death was unknown. The reported cause of death was myocarditis. The autopsy revealed "stress cardiomyopathy" (stress cardiomyopathy).  No follow-up attempts are possible. No further information is expected.; Sender's Comments: Based on the currently available information the possibility of causal association between the event myocarditis and the suspect drug BNT162B2  cannot be ruled out. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : PFIZER INC-202200277013 Same drug/event, different patient; Reported Cause(s) of Death: Myocarditis; Autopsy-determined Cause(s) of Death: stress cardiomyopathy