Fulminant Myocarditis After mRNA COVID-19 Vaccine Evolving to Giant Cell Myocarditis
Bibliographic record
Abstract
BACKGROUND: Pediatric inflammatory multisystem syndrome (PIMS-TS) is a rare entity observed in children with postinfectious hyperinflammatory syndrome. Cases have been reported, although rarely, after the mRNA SARS-CoV-2 (COVID-19) vaccine. CASE SUMMARY: We present a case of a young man who developed PIMS-TS with fulminant myocarditis after a first dose of COVID-19 vaccination, with persistent evidence of inflammation despite multiple lines of therapy over the course of 2 years. He then experienced fulminant myocarditis that was resistant to anti-inflammatory therapies. Repeat endomyocardial biopsy was consistent with giant cell myocarditis. DISCUSSION: Cases of giant cell myocarditis after COVID-19 vaccination have been reported in the past, however to our knowledge, none have been reported 2 years after a single dose and with intercurrent diagnosis of PIMS-TS myocarditis. This raises the question of a possible pathophysiologic association between the 2 diseases and immune dysregulation. TAKE-HOME MESSAGE: This case illustrates the importance of repeating the investigation and questioning the diagnosis when the progression of the disease is not typical.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".