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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References
- Deaths following vaccination: What does the evidence show?.Vaccine. 2015; 33: 3288-3292
- A prospective study of the incidence of myocarditis/pericarditis and new onset cardiac symptoms following smallpox and influenza vaccination.PLoS One. 2015; 10e0118283
- Acute Fulminant Myocarditis Following Influenza Vaccination Requiring Extracorporeal Membrane Oxygenation.Acute Crit Care. 2019; 34: 165-169
- A case of biopsy-proven eosinophilic myocarditis related to tetanus toxoid immunization.Cardiovasc Pathol. 2018; 37: 54-57
Article info
Publication history
Published online: May 12, 2020
Accepted:
May 3,
2020
Received:
February 8,
2020
Footnotes
See page 1554.e7 for disclosure information.
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of Canadian Cardiovascular Society.
