4.2 Article

Acute Lymphocyte Myocarditis Associated with Influenza Vaccination

Journal

INTERNAL MEDICINE
Volume 61, Issue 15, Pages 2307-2313

Publisher

JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.8855-21

Keywords

influenza vaccination; acute lymphocyte myocarditis; heart failure

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An elderly patient developed acute heart failure shortly after receiving influenza vaccination. Treatment with conventional heart failure drugs resulted in rapid recovery. Experimental data and clinical course suggested that influenza vaccination may have caused acute lymphocyte myocarditis leading to heart failure.
An elderly patient was admitted to our hospital for acute heart failure soon after receiving influenza vacci-nation. On admission, chest radiography revealed pulmonary edema. An electrocardiogram showed poor R progression, and echocardiography showed diffuse hypokinesis and myocardial edema. The serum troponin level was elevated. A histopathological evaluation indicated active myocarditis with lymphocyte-predominant infiltrates. A drug-induced lymphocyte stimulation test (DLST) was positive. The patient rapidly recovered from heart failure after treatment with conventional heart failure drugs, such as intravenous diuretics and vasodilators. These experimental data and the clinical course suggest that influenza vaccination was responsi-ble for heart failure due to acute lymphocyte myocarditis.

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