Acute pancreatitis following COVID-19 vaccine: A Vietnamese case report

Abstract

Several vaccines against the coronavirus 2 that causes severe acute respiratory syndrome have been developed in response to the global coronavirus infectious disease 2019 (COVID-19) pandemic. The FDA has established that the available vaccine is effective against both the original and current SARS-CoV-2 variant infections. The vaccine’s effectiveness and adverse effects also need to be evaluated comprehensively. Although the list of side effects of the mRNA COVID-19 vaccine has been reported, only a few cases of pancreatitis have been documented and published. The mechanism in this situation is unknown, and the onset time from the vaccination to symptom onset is variable through several case reports, so healthcare workers need to be suspicious of pancreatitis to make an early diagnosis and deliver the appropriate treatment. We report a 73-year-old man with controlled chronic hepatitis C and uncomplicated gastritis who presented to the hospital with a 4-day fever accompanied by chills, generalized myalgia, a bilateral temporal dull headache, and no abdominal discomfort or pain. A review of other systems was clinically negative after the second dose of the Pfizer/BioNTech mRNA COVID-19 vaccine. He had no history of alcohol consumption, pancreatitis, or allergic reactions to vaccines and had received the uncomplicated first dose of the Pfizer/BioNTech mRNA COVID-19 vaccine previously. Laboratory tests revealed elevated serum pancreatic enzymes. An abdominal magnetic resonance imaging study showed tail segment enlargement of the pancreas with fat stranding and fluid accumulation surrounding the tail of the pancreas, without any local or systemic complications detected. Other laboratory and imaging tests for the detected source of infections are negative, and acute pancreatitis was diagnosed based on the 2012 revision of the Atlanta classification and definitions by international consensus. The patient was diagnosed with COVID-19 vaccination-induced acute pancreatitis. The patient had an uneventful recovery with no complications. After administering the mRNA COVID-19 vaccine, acute pancreatitis could develop. Therefore, it is crucial to recognize acute pancreatitis when abdominal pain and/or abnormally increased pancreatic enzymes occur following a COVID-19 mRNA immunization.