New Onset Systemic Sclerosis-Polymyositis Overlap Syndrome FollowingSecond Dose of COVID-19 Vaccine – A Case Report

Abstract

Background: Coronavirus 2019 has been declared as a global emergency by the
World Health Organization. Vaccination has been shown to be crucial during the
COVID-19 pandemic. However, as global vaccination programs are implemented,
a number of COVID-19 vaccine-related side effects have lately been recorded,
including new-onset autoimmune disease. Overlap syndrome is a medical
disorder in which a patient has symptoms of at least two or more autoimmune
connective tissue diseases that meet the clinical criteria. Case Presentation: A
33-years-old woman with history of Graves’ disease presented with myalgia,
proximal superior and inferior extremities muscle weakness, skin thickening in
face and both superior and inferior extremities following the second dose of
inactivated whole virus COVID-19 vaccine. ANA test was found to be positive with
no specific antibody related to disease and there was an increase in muscle
enzyme. The patient was treated with combination of mycophenolic acid,
methylprednisolone, nifedipine, vit D3 and curcuma. After 4 months of treatment,
patient showed clinical improvement and decrease in muscle enzymes.
Conclusion: Systemic Sclerosis-Polymyositis overlap syndrome is an
autoimmune connective tissue disease that is frequently encountered in
conjunction with myositis. The causes of autoimmune disease are multifaceted,
involving genetic, environmental factors, and overstimulation of the immune
responses. The relationship between COVID-19 vaccination and autoimmune
disease, especially systemic sclerosis-polymyositis overlap syndrome, still
requires further study due to lack of reported evidence.