Moderna COVID-19 vaccine was linked to myocarditis or myopericarditis at 28 d (4.2 events/100 000 persons).

SOURCE CITATION: Husby A, Hansen JV, Fosbøl E, et al. SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study. BMJ. 2021;375:e068665. 34916207.

Dapsone hypersensitivity syndrome with myocarditis.

Drug hypersensitivity with myocarditis is known to occur with many drugs especially with antiepileptics, sulpha-compounds and daposne. Dapsone (4, 4 diaminodiphenyl sulphone) induced hypersensitivity is known to occur in about 2% of leprosy patients on treatment and an incidence of 1.66% in non-leprosy patients. We report this rare case of dapsone hypersensitivity syndrome in a girl on dapsone who presented with fever, anaemia, jaundice, skin rash, lymphadenopathy, and hepatomegaly and later developed myocarditis. The drug was withdrawn and the patient was treated with steroids. She improved and was discharged. She relapsed after the corticosteroids were discontinued at home.

[Cardiovascular function in leptospirosis convalescents]. / Sostoianie funktsii serdechno-sosudistoi sistemy u rekonvalestsentov posle leptospiroza.

AIM: To study mechanisms of cardiovascular damage in leprospirosis convalescents. MATERIALS AND METHODS: Cardiovascular system was investigated in 121 leptospirosis convalescents at the age 17-58 years clinically, electrocardiographically and measuring troponin-T in blood serum. RESULTS: 6-12 months after leptospirosis 42.1% of patients who had leptospiral jaundice (88.4%) and bovine leptospirosis (21.6%) myocardial damages were revealed. In spite of disappearance of cardiac pain ECG readings did not return to normal. The myocardial damage has developed in the advanced stage of leptospirosis due to rhandomyolis: high concentration of myoglobin and troponin-T in the blood serum confirms this suggestion. CONCLUSION: Clinical ECG readings as well as the level of troponin-T in the blood serum may be considered as the index of rehabilitation level in leptospirosis convalescents. It should be taken into consideration that 19.8% of the convalescents develop hypertension of renal genesis. This should be accounted for when planning prophylaxis and rehabilitation programs for young patients living in the North Caucasus--natural source of leptospirosis.

A fatal case of drug-induced multi-organ damage in a patient with Hansen's disease: dapsone syndrome or rifampicin toxicity?

An elderly patient with borderline tuberculoid Hansen's disease (leprosy) developed the diaminodiphenylsulphone syndrome after approximately 8 weeks of multi-drug therapy comprising dapsone and rifampicin. Postmortem histological examination, following autopsy, demonstrated features consistent with drug-induced hepatitis, tubulo-interstitial nephritis and myocarditis. Although these could have been engendered by dapsone toxicity, it was thought that a concommitant adverse reaction to rifampicin, which is known to be hepatotoxic, nephrotoxic and possibly capable of predisposing to the dapsone syndrome, could not be excluded.

Giant cell myocarditis and myositis associated with thymoma and leprosy.

Myocarditis is an inflammatory form of heart disease which is usually preceded by a viral infection. Giant cell myocarditis is an uncommon and nonspecific form of this disease. Sporadic reports have linked giant cell myocarditis with thymoma and concomitant myositis. The authors report a patient with leprosy who, six months after initiation of treatment, developed sudden onset of congestive heart failure and cardiac arrhythmias unresponsive to aggressive medical therapy. In addition to confirming leprosy, autopsy showed a mixed cell type thymoma, severe giant cell myocarditis and extensive myositis.