Woman Develops Retroperitoneal Fibrosis Following COVID-19 mRNA Vaccination

A 58-year-old woman experienced new-onset retroperitoneal fibrosis 5 weeks after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine, according to a case report published in the International Journal of Rheumatic Diseases. 

“Although [the vaccine] is reported to be safe and effective, immune dysregulation leading to autoimmunity has become an area of concern,” the rheumatology team said. “Retroperitoneal fibrosis is an immune-mediated fibroinflammatory disease characterized by the deposition of fibrous tissues, primarily around the abdominal aorta and iliac arteries.”

According to the report, the woman had no history of autoimmune disease and was in complete remission of stage 1 breast cancer, diagnosed 9 years earlier, when she presented with acute onset of epigastric pain. Computed tomography imaging of the abdomen revealed preaortic soft-tissue infiltration around the origin of the superior mesenteric artery. There were no signs of breast cancer recurrence.

“Considering the temporal relationship between current symptoms and vaccination and the absence of other possible causes, she was diagnosed with retroperitoneal fibrosis secondary to Pfizer-BioNTech vaccine-induced autoimmunity,” the team wrote. “This case may raise awareness of the possibility of retroperitoneal fibrosis development following COVID-19 mRNA vaccination.”

Reference:
Ture HY, Kim NR, Nam EJ. New-onset retroperitoneal fibrosis following COVID-19 mRNA vaccination: coincidental or vaccine-induced phenomenon? Int J Rheum Dis. Published online February 22, 2023. doi:10.1111/1756-185X.14621