A Case of SARS-CoV-2 Vaccination-Induced Mesenteric Vasculitis Improved by Adalimumab in Ankylosing Spondylitis

Hanna Lee1, Chiyeon Kim2 and Sang-Il Lee3*

1Department of Internal Medicine and Institute of Health Science, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, South Korea 2Department of Dermatology and Institute of Health Science, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, South Korea 3Department of Internal Medicine and Institute of Health Science, Division of Rheumatology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, South Korea

^*Correspondance to: Sang-Il Lee 

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Abstract:

Recently, SARS-CoV-2 vaccines have been reported to increase the incidence of immune-mediated diseases, including systemic vasculitis, in various rheumatic diseases. Herein, we report a case of severe mesenteric vasculitis following administration of an mRNA vaccine (Johnson and Johnson Ad26.COV2.S) in a patient with ankylosing spondylitis. A 49-year-old woman presented with massive hematochezia and multiple erythematous purpuric papules throughout her body after a single-dose inoculation with SARS-CoV-2 vaccine. Mesenteric vasculitis was diagnosed based on clinical investigation, abdominal computed tomography, colonoscopy, and skin biopsy. Her symptoms worsened after high-dose steroid therapy but dramatically responded to adalimumab treatment. The findings from this case suggest a causal relationship between the SARS-CoV-2 vaccine and mesenteric vasculitis, and the therapeutic advantage of TNF-α inhibitors for this severe complication.

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Cite the Article:

Lee H, Kim C, Sang-Il Lee. A Case of SARS-CoV-2 Vaccination-Induced Mesenteric Vasculitis Improved by Adalimumab in Ankylosing Spondylitis. Ann Clin Case Rep. 2022; 7: 2168..