AB0715 Anti-MDA5 Dermatomyositis after BNT162b2 vaccination

Background Background: Anti-Melanoma Differentiation-Associated gene 5 (MDA-5) Dermatomyositis (MDA5, DM) is a rare systemic autoimmune disease, characteristically associated with Rapidly Progressive Interstitial Lung Disease (RP-ILD) and cutaneous manifestations. Anti-MDA5 dermatomyositis may develop in genetically predisposed subjects after environmental exposure such as vaccines, infections neoplasms (1). Myalgia one of the main symptoms related to SARS-COV2 infection sometimes occurs COVID-19 vaccine administration (2). However, only few cases have reported occurrence severe inflammatory myopathies COVID19 (3) Objectives To describe case occurred BNT162b2 Methods This 44 year-old-patient affected by vaccination referred at Center for Rheumatic Diseases Venice, Italy Results A year-old-woman presented suffering from cutaneus rash on her face, upper limbs, décolleté, gluteus lower limbs two days first dose (Figure 1). second got worse myalgias, strength deficiency fatigue occurred. Elevated myocytolysis parameters were detected (Table After chest HRCT mild ILD was diagnosed. Muscle edema whole-body short tau inversion recovery (STIR)-MRI 1).The Skyn biopsy showed features perivascular infiltrates. 1 mg/Kg/die prednisone administered then cyclosporine 3mg/kg/die clinical benefit. Table 1. Clinical laboratory characteristics patient Age (years) Sex Female Previous Rheumatological diagnosis - Vaccination reaction Time onset COVID 19 2 MMT-8* 124/150 (150/150) Blood Tests Hb* (12-16 g/dl) 11,5 g/dl CRP* (< mg/L) 23,4 mg/L AST* (31 U/L) 98 U/L ALT* (1-34 63 CPK * (10-145 1085 Aldolase (0-7,6) 13,2 SARS-CoV-2 RT PCR negative Autoantibodies ANA* 1:1280 nucleolar Myositis antibodies HLA- DRB1 03-04 HLA-DQB 02-03 MMT-8 MANUAL MUSCLE TESTING; Hb Hemoglobin; WBC withe blood cells count; CRP C-reactive proteine; AST Aspartate amino transferase; ALT Alanine creatinine phosphokinase; ANA anti nuclear antibodies, ENA extractable antigens; HLA Human Leukocyte Antigen Conclusion In could induce (3). acted trigger myopathy driven an autoimmune-mechanism. cases, it be useful investigate myopathies, requiring tests (e.g. indices myositis antibodies) medical instrumental insights, patients skin manifestation muscle pain administration. Although association between presumptive, temporal proximity signs miopathies suggest possible relationship these events. best our knowledge this vaccination. References [1]Mehta P, Machado P.m, Gupta L. Understanding managing anti-MDA dermatomyositis, including potential mimicry. Rheumatol Int 2021 Jun;41(6):1021-1036 [2]Beatty A.L, Peyser N.D, Butcher X.E, Cocohoba J.M, Lin F, Olgin J.E, Pletcher M.J, Marcus G.M. Vaccine side-effects users Symptom Study app UK: prospective observational study Lancet Infect Dis 2021; 21: 939–49 [3]Maramattom B.V, Philips G, Thoas J, Santhamma Nair S.G. Inflammatory ChAdOx1 The Rheumatology Volume 3, ISSU 11, e747-e749, November 01.2021 Disclosure Interests None declared