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 distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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 teacher head, 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".