First Presentation of Systemic Lupus Erythematosus in a 24-Year-Old Male following mRNA COVID-19 Vaccine

Table 1

Chronology of clinical manifestations, laboratory results, and treatment.

	Day 0, administration of SARS-CoV-2 Pfizer-BioNTech mRNA vaccine	Day +2, visits family physician	Day +10, visits family physician	Day +33	Day +59	Day +62, presentation to the SUMC	Day +63, diagnosis made of SLE
Clinical manifestations		Appearance of facial rash; nonspecific joint pain	Facial rash, morning stiffness, arthralgia, and fatigue	Progression of rash on the face, neck, and arms, nonscarring hair loss over the head, joint pain, and stiffness		Psoriasiform-papulosquamous plaques over the face, neck, and arms, nonscarring hair loss over the head, stress pain at the wrists without a sign of effusion, and joint pain with morning stiffness lasting up to two hours
Treatment		Calamine topical	Calamine topical and fexofenadine trima tablet 180 mg				Hydroxychloroquine 200 mg BID; mometasone furoate cream 0.1% for topical use QD; and etoricoxib 90 mg QD as needed
Laboratory testing					Positive COVID-19-neutralizing antibodies	ANA:1:160, with a speckled pattern and positive anti-chromatin (nucleosomal) and ribosome P antibodies (1.6AI, >8.0AI, respectively). C3 and C4 levels: 70 mg/dL and 21 mg/dL, respectively

ANA: antinuclear antibody, SLE: systemic lupus erythematosus, and SUMC : Soroka University Medical Center.