Age: 56.0
Sex: F
Vaccine: COVID19
Symptoms: Autoimmune pericarditis, Dermatologic examination, Echocardiogram, Electrocardiogram, Guttate psoriasis
Clinical narrative: This spontaneous case was reported by a nurse and describes the occurrence of PSORIATIC ARTHROPATHY (Psoriatic Arthritis), AUTOIMMUNE PERICARDITIS (Pericarditis secondary to Autoimmune disease) and PERICARDITIS (Pericarditis) in a 56-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 025L20A and 011L20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Pericarditis (Viral Cause. Would happen after patient had a Herpes Cold Sore.) in 2020. On 01-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 01-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 13-Feb-2021, the patient experienced GUTTATE PSORIASIS (guttate psoriasis). 13-Feb-2021, the patient experienced PSORIASIS (inverse psoriasis). On 04-Oct-2021, the patient experienced AUTOIMMUNE PERICARDITIS (Pericarditis secondary to Autoimmune disease) (seriousness criterion medically significant). 04-Oct-2021, the patient experienced MOBILITY DECREASED (Patient could not walk or move). On 05-Oct-2021, the patient experienced PSORIATIC ARTHROPATHY (Psoriatic Arthritis) (seriousness criterion medically significant) and PERICARDITIS (Pericarditis) (seriousness criterion medically significant). On an unknown date, the patient experienced HEADACHE (bad headaches). The patient was treated with TRIAMCINOLONE ACETONIDE at an unspecified dose and frequency; ULOBETASOL (HALOBETASOL) at an unspecified dose and frequency; RISANKIZUMAB (SKYRIZI [RISANKIZUMAB]) on 24-Mar-2022 at an unspecified dose and frequency; PREDNISONE at a dose of 40 milligram once a day; IBUPROFEN (MOTRIN [IBUPROFEN]) at a dose of UNK, TID and VALACICLOVIR HYDROCHLORIDE (VALTREX) at an unspecified dose and frequency. On 04-Nov-2021, AUTOIMMUNE PERICARDITIS (Pericarditis secondary to Autoimmune disease) and PERICARDITIS (Pericarditis) had resolved. At the time of the report, PSORIATIC ARTHROPATHY (Psoriatic Arthritis), GUTTATE PSORIASIS (guttate psoriasis), PSORIASIS (inverse psoriasis), MOBILITY DECREASED (Patient could not walk or move) and HEADACHE (bad headaches) outcome was unknown. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 31-Aug-2021, Dermatologic examination: right distal lateral calf-psoriasis, (abnormal) right distal lateral calf-psoriasis, left anterior proximal thigh - psoriasis. PAS stain negative for hyphae. On 22-Oct-2021, Protein total (15-45): 72.0 (High) 72.0 mg/dL. On an unknown date, Echocardiogram: pericarditis (abnormal) Echocardiogram showed Pericarditis. On an unknown date, Electrocardiogram: normal (normal) Normal. On an unknown date, Lumbar puncture: patient was sent to hospital for lubar puncture Patient was sent to hospital for lubar puncture. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient's symptoms included - Few red dots on left leg, red dots on right leg on 13-Feb-2021. In May, the red dots became larger and had red dots on thighs, arms, and dots continued on legs. The dots continued to get larger, progression of them. The dots itched from 13-Feb-2021. The patient was sent to the hospital for lumbar puncture. Symptoms of Pericarditis included chest pressure and shortness of breath. The symptoms started on 04-Oct-2021 and resolved on 04-Nov-2021. No Palpitations/pericardial rub, Syncope, Myocardial edema/cardiomyopathy/pericardial effusion/infective pericardial effusion/pericardial effusion malignant. Date of previous pericarditis: 2020 (Patient was not entirely sure). The Viral Cause was determined. Reported that it would happen after patient had a Herpes Cold Sore. No upper limit of normal value for Troponin level. No Cardiac function test abnormal. No MRI heart performed. No history of Covid infection. No hospitalization due to pericarditis. On an unknown date, cardiologic test performed. Results - Ejection fraction: 60-65%, trivial aortic regurgitation, trace mitral regurgitation, trace tricuspid regurgitation, trace pulmonic regurgitation, evidence of pericardial thickening/calcification present. No evidence of pericardial effusion. Treatment medications included High dose steroids. Most recent FOLLOW-UP information incorporated above includes: On 30-Mar-2022: Updated lab data and case narrative. Sender's Comments: Company comment: This is a spontaneous case concerning a 56-year-old female patient with past medical history of Pericarditis (after viral infection) in 2020, who experienced the non-serious unexpected events guttate psoriasis and the serious (medically significant) unexpected events headache, Psoriatic arthritis and autoimmune pericarditis, after receiving the second dose of mRNA-1273. Approximately 12 days after vaccination patient noticed red dots on legs that progressed on number and extension. After seeing a dermatologist was diagnosed with guttate psoriasis and inverse psoriasis. Almost 8 months later was diagnosed with psoriatic arthritis due to decreased mobility and start treatment with high dose steroids. Also had headache and had a lumbar puncture with elevated protein 72 mg/dl (15-45). At the same period, patient experienced chest discomfort and dyspnea and echocardiogram showed pericarditis, assumed secondary to autoimmune disease. The benefit-risk relationship of mRNA-1273 is not affected by this report.