{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:43:45Z","timestamp":1788435825168,"version":"build-2803163510"},"reference-count":26,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:p>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\u2009mg\/L, white cell count of 17\u00d710<jats:sup>9<\/jats:sup>\/L (1.8\u20137.5), troponin-T of 1013\u2009ng\/L and creatine kinase of 572\u2009u\/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.<\/jats:p>","DOI":"10.1136\/bcr-2021-243888","type":"journal-article","created":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T17:28:06Z","timestamp":1627579686000},"page":"e243888","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":84,"title":["Multisystem inflammatory syndrome in an adult following the SARS-CoV-2 vaccine (MIS-V)"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3849-614X","authenticated-orcid":false,"given":"Arvind","family":"Nune","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4379-1266","authenticated-orcid":false,"given":"Karthikeyan P","family":"Iyengar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Goddard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashar E","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,7,29]]},"reference":[{"key":"2021072908502036000_14.7.e243888.1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2034577"},{"key":"2021072908502036000_14.7.e243888.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2027906"},{"key":"2021072908502036000_14.7.e243888.3","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1056\/NEJMra2035343","article-title":"Maintaining safety with SARS-CoV-2 vaccines","volume":"384","author":"Castells","year":"2021","journal-title":"N Engl J Med"},{"key":"2021072908502036000_14.7.e243888.4","unstructured":"World Health Organization . Who coronavirus disease (COVID-19) Dashboard, 2020. Available: https:\/\/covid19.who.int\/ [Accessed 10 Apr 2021]."},{"key":"2021072908502036000_14.7.e243888.5","doi-asserted-by":"publisher","DOI":"10.1038\/d41586-021-00290-x"},{"key":"2021072908502036000_14.7.e243888.6","doi-asserted-by":"crossref","DOI":"10.1097\/CCE.0000000000000397","article-title":"Prolonged anaphylaxis to pfizer coronavirus disease 2019 vaccine: a case report and mechanism of action","volume":"3","author":"Frank","year":"2021","journal-title":"Crit Care Explor"},{"key":"2021072908502036000_14.7.e243888.7","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1056\/NEJMoa2104882","article-title":"Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination","volume":"384","author":"Schultz","year":"2021","journal-title":"N Engl J Med"},{"key":"2021072908502036000_14.7.e243888.8","doi-asserted-by":"crossref","unstructured":"Oldenburg J , Klamroth R , Langer F . Diagnosis and management of vaccine-related thrombosis following AstraZeneca COVID-19 vaccination: guidance statement from the GTH. Hamostaseologie 2021;41.","DOI":"10.1055\/a-1469-7481"},{"key":"2021072908502036000_14.7.e243888.9","doi-asserted-by":"crossref","first-page":"2092","DOI":"10.1056\/NEJMoa2104840","article-title":"Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination","volume":"384","author":"Greinacher","year":"2021","journal-title":"N Engl J Med"},{"key":"2021072908502036000_14.7.e243888.10","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1002\/ejhf.1531","article-title":"Clinical practice update on heart failure 2019: pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the heart failure association of the European Society of cardiology","volume":"21","author":"Seferovic","year":"2019","journal-title":"Eur J Heart Fail"},{"key":"2021072908502036000_14.7.e243888.11","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.cell.2020.09.016","article-title":"The immunology of multisystem inflammatory syndrome in children with COVID-19","volume":"183","author":"Consiglio","year":"2020","journal-title":"Cell"},{"key":"2021072908502036000_14.7.e243888.12","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2094"},{"key":"2021072908502036000_14.7.e243888.13","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1007\/s00296-020-04749-4","article-title":"Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management","volume":"41","author":"Kabeerdoss","year":"2021","journal-title":"Rheumatol Int"},{"key":"2021072908502036000_14.7.e243888.14","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/jpids\/piaa061","article-title":"COVID-19-Associated pediatric multisystem inflammatory syndrome","volume":"9","author":"Deza Leon","year":"2020","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2021072908502036000_14.7.e243888.15","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30651-4"},{"key":"2021072908502036000_14.7.e243888.16","unstructured":"Centers for Disease Control and Prevention . Emergency Preparedness and Response: Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). Health Alert Network, 2020. Available: https:\/\/emergency.cdc.gov\/han\/2020\/han00432.asp [Accessed 10 Apr 2021]."},{"key":"2021072908502036000_14.7.e243888.17","doi-asserted-by":"crossref","first-page":"3037","DOI":"10.1016\/j.vaccine.2021.01.054","article-title":"Multisystem inflammatory syndrome in children and adults (MIS-C\/A): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data","volume":"39","author":"Vogel","year":"2021","journal-title":"Vaccine"},{"key":"2021072908502036000_14.7.e243888.18","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6932e2"},{"key":"2021072908502036000_14.7.e243888.19","doi-asserted-by":"publisher","DOI":"10.100\/jama.2020.10369"},{"key":"2021072908502036000_14.7.e243888.20","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.048360"},{"key":"2021072908502036000_14.7.e243888.21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021680"},{"key":"2021072908502036000_14.7.e243888.22","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021756"},{"key":"2021072908502036000_14.7.e243888.23","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6940e1"},{"key":"2021072908502036000_14.7.e243888.24","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1016\/j.vaccine.2016.09.033","article-title":"Kawasaki disease and immunisation: a systematic review","volume":"35","author":"Phuong","year":"2017","journal-title":"Vaccine"},{"key":"2021072908502036000_14.7.e243888.25","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1056\/NEJMc2102131","article-title":"Delayed large local reactions to mRNA-1273 vaccine against SARS-CoV-2","volume":"384","author":"Blumenthal","year":"2021","journal-title":"N Engl J Med"},{"key":"2021072908502036000_14.7.e243888.26","doi-asserted-by":"crossref","unstructured":"Gupta A , Gill A , Sharma M , et al . Multi-System inflammatory syndrome in a child mimicking Kawasaki disease. J Trop Pediatr;395.doi:10.1093\/tropej\/fmaa060","DOI":"10.1093\/tropej\/fmaa060"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243888","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T17:28:25Z","timestamp":1627579705000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243888"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7]]},"references-count":26,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,29]]},"published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1136\/bcr-2021-243888"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243888","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7]]}}}