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Multisystem inflammatory syndrome in an adult following the SARS-CoV-2 vaccine (MIS-V)
  1. Arvind Nune1,
  2. Karthikeyan P Iyengar2,
  3. Christopher Goddard3 and
  4. Ashar E Ahmed1
  1. 1Department of Rheumatology, Southport and Ormskirk Hospital NHS Trust, Southport, Sefton, UK
  2. 2Trauma & Orthopaedics, Southport and Ormskirk Hospital NHS Trust, Southport, UK
  3. 3Intensive Care, Southport and Ormskirk Hospital NHS Trust, Southport, Sefton, UK
  1. Correspondence to Dr Arvind Nune; Arvind.nune{at}


SARS-CoV-2 vaccine roll-out has been successful in the UK and other parts of the world; however, there are increasing concerns about adverse events. A 44-year-old woman presented to a UK hospital with left upper arm pain at the vaccine site a couple of days after receiving the Pfizer-BioNTech mRNA vaccine, which progressed to fever, diarrhoea and abdominal pain over the next few days. She had an erythematous rash on the chest with subcutaneous oedema. Her C reactive protein was 539 mg/L, white cell count of 17×109/L (1.8–7.5), troponin-T of 1013 ng/L and creatine kinase of 572 u/L. She developed an unprovoked pulmonary embolism with acute kidney injury. After administration of intravenous methylprednisolone, the muscle oedema, skin rashes and acute kidney injury resolved. Although multisystem inflammatory syndrome (MIS) is described in children (MIS-C) and adults (MIS-A) following SARS-CoV-2 infection, we highlight the first reported MIS-V case after the SARS-CoV-2 vaccine.

  • COVID-19
  • immunological products and vaccines
  • vaccination/immunisation
  • intensive care

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  • Contributors AN has conceptualised and designed the work. AN, KPI, CG and AEA have contributed individually and as a group to writing this case report regarding the planning, conduct, reporting and acquisition of data or analysis and interpretation of data.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.