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Canadian Journal of Cardiology

Hemodynamic Collapse After Influenza Vaccination: A Vaccine-Induced Fulminant Myocarditis?

      Abstract

      A 14-year-old girl with cardiopulmonary arrest was referred to our hospital. She had received an injection of inactivated influenza vaccine 7 days before the referral. Her cardiac rhythm was pulseless wide QRS tachycardia, and mechanical circulatory support was immediately begun. Results of endomyocardial biopsy showed that there was massive infiltration of CD3- and CD68-positive cells and various degrees of cardiomyocyte necrosis in all of 3 endomyocardial specimens, whereas infiltration of eosinophils or giant cells was not observed. A histologic diagnosis of lymphocytic myocarditis was made. Acute myocarditis is a rare but potentially fatal complication of the influenza vaccination.

      Résumé

      Une jeune fille de 14 ans en arrêt cardiorespiratoire a été orientée vers notre hôpital. La patiente, qui avait reçu un vaccin inactivé contre la grippe 7 jours auparavant, présentait une tachycardie sans pouls et un complexe QRS élargi, et a été immédiatement mise sous assistance circulatoire mécanique. Les résultats d’une biopsie endomyocardique ont révélé une infiltration massive de cellules exprimant le CD3 et le CD68 et une nécrose des cardiomyocytes à divers degrés dans les trois échantillons prélevés; on n’a toutefois pas observé d’infiltration d’éosinophiles ou de cellules géantes. Un diagnostic histologique de myocardite lymphocytaire a été posé. La myocardite aiguë est une complication rare, mais potentiellement mortelle de l’administration d’un vaccin contre la grippe.
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