Drug-induced sarcoidosis-like reaction three months after BNT162b2 mRNA COVID-19 vaccination:A case report and review of literature

作     者：Soo Ryang Kim Soo Ki Kim Takako Fujii Hisato Kobayashi Toyokazu Okuda Takanobu Hayakumo Atsushi Nakai Yumi Fujii Ryuji Suzuki Noriko Sasase Aya Otani Yu-ichiro Koma Motoko Sasaki Tsutomu Kumabe Osamu Nakashima 

作者机构：Department of GastroenterologyKobe Asahi HospitalKobe 6530801HyogoJapan Department of RadiologyKobe Asahi HospitalKobe 6530801HyogoJapan Department of Clinical LaboratoryKobe Asahi HospitalKobe 6530801HyogoJapan Department of PharmacyKobe Asahi HospitalKobe 6530801HyogoJapan Division of PathologyDepartment of PathologyKobe University Graduate School of MedicineKobe 6530801HyogoJapan Department of Human PathologyKanazawa University Graduate School of MedicineKanazawa 9208640IshikawaJapan Department of GastroenterologyKumabe ClinicKumamoto 8611331KumamotoJapan Laboratory Services CenterSt.Mary's HospitalKurume 830-8543FukuokaJapan 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2023年第11卷第1期

页      面：177-186页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：Japan Society for the Promotion of Science  JSPS  (22K06957) 

主　　题：Drug-induced sarcoidosis-like reaction BNT162b2 mRNA COVID-19 vaccine Noncaseating granuloma Ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging Th1/Th2 profile Case report 

摘      要：BACKGROUND A 70-year-old man with hepatitis C virus-related recurrent hepatocellular carcinoma was admitted for further diagnosis of a 1 cm iso-hyperechoic nodule in segment(S)*** SUMMARY Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging(EOB-MRI)revealed the nodule in S5 with a defect at the hepatobiliary phase,hyperintensity on diffusion weighted imaging(DWI)and hypointensity on apparent diffusion coefficient(ADC)***-enhanced computed tomography revealed hypervascularity at the early phase,and delayed contrast-enhancement was observed at the late ***-enhanced ultrasound(US)revealed incomplete defect at the late vascular *** liver tumor,lymphoproliferative disease,intrahepatic cholangiocarcinoma(small duct type)and bile duct adenoma were suspected through the imaging *** guided biopsy,however,showed a noncaseating hepatic sarcoid-like epithelioid granuloma(HSEG),and histopathological analysis disclosed spindle shaped epithelioid cells harboring Langhans-type multinucleated giant *** month after admission,EOB-MRI signaled the disappearance of the defect at the hepatobiliary phase,of hyperintensity on DWI,of hypointensity on ADC map,and no stain at the early *** That the patient had received BNT162b2 messenger RNA(mRNA)coronavirus disease 2019 vaccination 3 mo before the occurrence of HSEG,and that its disappearance was confirmed 4 mo after mRNA vaccination suggested that the drug-induced sarcoidosis-like reaction(DISR)might be induced by the mRNA ***,rechallenge of drug-induced DISR with the third mRNA vaccination was not confirmed.