PDF(Pubmed)
Abstract：
During the COVID-19 pandemic, anti-SARS-CoV-2 vaccines were quickly developed and administered to the population worldwide. As is expected with new vaccine products, adverse reactions following immunization have been reported, namely, the development and/or exacerbation of autoimmune/autoinflammatory diseases, including rheumatic diseases. Here, we report a clinical case of a 56-year-old woman with a 44-year history of moderate-to-severe plaque psoriasis under treatment with an anti-tumor necrosis factor alpha biosimilar (adalimumab) with good control of skin disease and without rheumatic involvement to date who came to us with complaints of migratory polyarthralgia starting one week after receiving the second dose of the BNT162b2 COVID-19 mRNA vaccine. The condition progressed over the following months and a diagnosis of psoriatic arthritis was established. Biologic treatment was switched to an anti-interleukin 17A (secukinumab), with a very good clinical cutaneous and articular response, which was sustained up to the present moment. The mechanisms behind the exacerbation or new-onset of autoimmune/autoinflammatory diseases after receiving anti-COVID-19 vaccines are not yet fully understood, requiring further investigation. It is also not known whether rheumatic symptoms post-COVID-19 infection will have similar mechanisms to rheumatic symptoms post-anti-COVID-19 vaccination. With the continuing worldwide vaccination against SARS-CoV-2, clinicians need to be prepared to discuss the risks and benefits of vaccination and should be aware that it may cause or exacerbate immune disorders such as psoriatic arthritis, warranting close follow-up in terms of disease progression and treatment.
摘要：
在COVID-19大流行期间，抗SARS-CoV-2疫苗被迅速开发并应用于全世界的人群。正如预期的那样，新的疫苗产品，免疫接种后的不良反应已有报道，即,自身免疫/自身炎性疾病的发展和/或恶化，包括风湿性疾病.这里,我们报道了1例56岁女性患者的临床病例,该患者有44年的中重度斑块型银屑病病史,接受抗肿瘤坏死因子α生物仿制药(阿达木单抗)治疗,皮肤病得到良好控制,迄今未出现风湿性受累,该患者在接受第二剂BNT162b2COVID-19mRNA疫苗后1周开始出现游走性多关节痛的主诉.在接下来的几个月中病情进展，并确定了银屑病关节炎的诊断。生物治疗改为抗白细胞介素17A（苏金单抗），具有非常好的临床皮肤和关节反应，一直持续到现在。在接受抗COVID-19疫苗后，自身免疫性/自身炎症性疾病恶化或新发的机制尚未完全了解，需要进一步调查。目前还不清楚COVID-19感染后的风湿性症状是否会与抗COVID-19疫苗接种后的风湿性症状具有相似的机制。随着全球范围内针对SARS-CoV-2的持续疫苗接种，临床医生需要准备好讨论疫苗接种的风险和益处，并且应该意识到它可能导致或加剧免疫疾病，例如银屑病关节炎。在疾病进展和治疗方面需要密切随访。
