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Misaki Y, Hayashi Y, Shirata M, Terada K, Yoshizawa A, Sakamoto R, Ikezoe K, Tanizawa K, Handa T, Hirai T. Resolution of Eosinophilic Pneumonia after Coronavirus Disease 2019 without Systemic Corticosteroids. Intern Med 2023; 62:3223-3230. [PMID: 37587039 PMCID: PMC10686740 DOI: 10.2169/internalmedicine.1648-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/02/2023] [Indexed: 08/18/2023] Open
Abstract
Pulmonary and extrapulmonary complications after coronavirus disease 2019 (COVID-19) have been major public health concerns during the COVID-19 pandemic. Although post-COVID-19 pulmonary manifestations cover a wide spectrum, eosinophilic pneumonia (EP) has rarely been reported. To date, only four cases of EP potentially triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been reported, all of which required systemic corticosteroid therapy. We herein report the first case of post-COVID-19 EP resolution without systemic corticosteroid therapy. We also review the literature regarding EP associated with SARS-CoV-2 infection and vaccination.
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Affiliation(s)
- Yumiko Misaki
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Japan
| | - Yusuke Hayashi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Japan
| | - Masahiro Shirata
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Japan
- Department of Respiratory Medicine, Kyoto Preventive Medical Center, Japan
| | - Kazuhiro Terada
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Japan
| | - Akihiko Yoshizawa
- Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Japan
| | - Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Japan
| | - Kohei Ikezoe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Japan
| | - Kiminobu Tanizawa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Japan
| | - Tomohiro Handa
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Japan
- Department of Advanced Medicine for Respiratory Failure, Graduate School of Medicine, Kyoto University, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Japan
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2
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Koda T, Natsumoto B, Shoda H, Fujio K. Nonepisodic Angioedema with Eosinophilia Following Receipt of the BNT162b2 mRNA COVID-19 Vaccine. Intern Med 2023; 62:3063-3067. [PMID: 37468248 PMCID: PMC10641185 DOI: 10.2169/internalmedicine.1788-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/07/2023] [Indexed: 07/21/2023] Open
Abstract
Angioedema with eosinophilia (AE) is a rare disease of unknown etiology characterized by episodic (EAE) or nonepisodic AE (NEAE). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA-based vaccines function as immunogens and intrinsic adjuvants and have been shown to be safe in large-scale trials. However, the long-term adverse reactions, especially those related to eosinophilic complications, have not been fully clarified. We herein report a case of self-limited but severe NEAE that developed in a young woman one week after receiving the second BNT162b2 mRNA vaccine. The symptoms that impaired her activities of daily living, such as edema, gradually resolved with supportive care over 10 weeks without corticosteroid treatment.
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Affiliation(s)
- Tamaki Koda
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Bunki Natsumoto
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Hirofumi Shoda
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Japan
| | - Keishi Fujio
- Department of Allergy and Rheumatology, Graduate School of Medicine, The University of Tokyo, Japan
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3
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Bocchi C, Marzola E, Pedriali M, Borghi A, Corazza M. Wells' Syndrome associated with COVID-19 vaccination. Ital J Dermatol Venerol 2023; 158:374-375. [PMID: 37539510 DOI: 10.23736/s2784-8671.23.07591-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Affiliation(s)
- Chiara Bocchi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy -
| | - Elisa Marzola
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Massimo Pedriali
- Section of Anatomopathology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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Doman T, Saito H, Tanaka Y, Hirasawa D, Endo M, Togo D, Matsuda T. Colitis with Hypereosinophilia following the Second Dose of the BNT162b2 mRNA COVID-19 Vaccine: A Case Report with a Literature Review. Intern Med 2023; 62:865-869. [PMID: 36575012 PMCID: PMC10076129 DOI: 10.2169/internalmedicine.0518-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
A 61-year-old man presented with a 7-day history of watery diarrhea and loss of appetite after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. Laboratory studies showed significant eosinophilia and an elevated IgE level (white cell count, 18.4×109/L; eosinophil count, 9.5×109/L; and IgE level, 540 IU/L). Symptoms resolved 10 days after vaccination without any steroids or antiallergic medications, and the eosinophil count had also returned to within normal limits 2 months later. Several cases of eosinophilic disorders following receipt of any type of injectable COVID-19 vaccine have been reported, so the etiology should be examined.
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Affiliation(s)
- Tsuyoshi Doman
- Department of Gastroenterology, Sendai Kousei Hospital, Japan
- Graduate Medical Education Center, Tohoku University Hospital, Japan
| | - Hiroaki Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Japan
| | - Yukari Tanaka
- Department of Gastroenterology, Sendai Kousei Hospital, Japan
| | - Dai Hirasawa
- Department of Gastroenterology, Sendai Kousei Hospital, Japan
| | - Mareyuki Endo
- Department of Pathology, Sendai Kousei Hospital, Japan
| | - Daichi Togo
- Department of Gastroenterology, Sendai Kousei Hospital, Japan
| | - Tomoki Matsuda
- Department of Gastroenterology, Sendai Kousei Hospital, Japan
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Westreich A, Zelarney P, Wechsler ME. Hypereosinophilia after vaccination with the SARS-CoV-2 mRNA vaccines. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1564-1566. [PMID: 36720388 PMCID: PMC9884606 DOI: 10.1016/j.jaip.2023.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/22/2022] [Accepted: 01/02/2023] [Indexed: 01/31/2023]
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Kaya A, Kaya SY, Abul A, Fener N, Can A, Mert A. Eosinophilic lymph node abscesses following a COVID-19 vaccination: A case report. J Natl Med Assoc 2023; 115:144-146. [PMID: 36681552 PMCID: PMC9837217 DOI: 10.1016/j.jnma.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/05/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
In this paper, we reported a 37-year-old man who developed several lymphadenopathies after using the second dose of Pfizer-BioNtech vaccination against SARS-CoV-2. The excisional lymph node biopsy showed eosinophil-rich inflammation with micro-abscesses. Although eosinophilic dermatosis and eosinophilic myocarditis have been described previously following COVID-19 vaccinations, eosinophilic lymph node abscess was not reported in the literature. In our case, all lesions were completely recovered with steroid treatment. The patient has been doing well and no recurrence has been observed for six months.
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Affiliation(s)
- Abdurrahman Kaya
- Department of Infectious Diseases, İstanbul Training and Research Hospital,Corresponding author at: Department of Infectious Disease, İstanbul Training and Research Hospital, Istanbul Turkey
| | - Sibel Yıldız Kaya
- Department of Infectious Diseases, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa
| | - Azat Abul
- Department of Infectious Diseases, İstanbul Training and Research Hospital
| | - Neslihan Fener
- Department of pathology, Yedikule chest diseases and thoracic surgery training and research hospital
| | - Ali Can
- Department of Internal Medicine, Division of Immunology and Allergic disease, Van Training and Research Hospital
| | - Ali Mert
- Infectious Diseases and Clinical Microbiology, Faculty of Medicine, İstanbul Medipol University
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Lee JY, Lee JH. mRNA COVID-19 Vaccine-Associated Subserosal Eosinophilic Gastroenteritis: A Case Report. J Korean Med Sci 2022; 37:e233. [PMID: 35916045 PMCID: PMC9344039 DOI: 10.3346/jkms.2022.37.e233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/24/2022] [Indexed: 11/20/2022] Open
Abstract
The World Health Organization declared coronavirus disease 2019 (COVID-19) a global pandemic in March 2020. Several vaccines have been developed to overcome the COVID-19 pandemic, and messenger RNA vaccines, commonly known as mRNA vaccines, were the first COVID-19 vaccines to be authorized in Korea. With the worldwide increase in vaccinations, reports of adverse reactions are increasing. However, to the best of our knowledge, there have been no reports of eosinophilic gastroenteritis (EGE) following mRNA vaccination. Here, we present the first case of EGE in a patient who received a second dose of the mRNA vaccine, BNT162b2 (Pfizer-BioNTech). A previously healthy 34-year-old woman presented to the emergency department with generalized abdominal pain for the preceding 2 weeks. She had received a second dose of the mRNA COVID-19 vaccine 2 weeks prior. Subserosal EGE was diagnosed, oral prednisolone was administered, and she recovered completely.
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Affiliation(s)
- Jong Yoon Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea
| | - Jong Hoon Lee
- Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
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Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2022; 36:1947-1968. [PMID: 35666609 PMCID: PMC9348179 DOI: 10.1111/jdv.18294] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/18/2022] [Indexed: 01/08/2023]
Abstract
Although vaccination is widely accepted as an effective method of preventing and controlling the COVID-19 pandemic, many people are concerned about possible cutaneous side effects which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination. PubMed and Scopus databases were searched for articles published from January 1, 2019, to December 31, 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies, and randomized controlled trials that provided information on cutaneous adverse reactions following COVID-19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946,366 participants were included in the meta-analysis. The pooled prevalence of cutaneous manifestations following COVID-19 vaccination was 3.8% (95% CI, 2.7%-5.3%). COVID-19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%-12.3%). Various cutaneous manifestations have been reported from injection site reactions which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre-existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID-19 vaccination may also be associated with flares of pre-existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre-existing skin conditions, or scheduled for filler injections should receive additional pre-counseling and monitoring. A better understanding of potential side effects may strengthen public confidence in those wary of new vaccine technologies.
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Affiliation(s)
- C Washrawirul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Triwatcharikorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M Ullman
- Department of Research Affairs, Chulalongkorn University, Bangkok, Thailand
| | - P Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Rerknimitr
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
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Avallone G, Quaglino P, Cavallo F, Roccuzzo G, Ribero S, Zalaudek I, Conforti C. SARS-CoV-2 vaccine-related cutaneous manifestations: a systematic review. Int J Dermatol 2022; 61:1187-1204. [PMID: 35141881 PMCID: PMC9111829 DOI: 10.1111/ijd.16063] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/10/2021] [Accepted: 12/30/2021] [Indexed: 12/14/2022]
Abstract
To date, over 250 million people have been reportedly infected by COVID‐19 disease, which has spread across the globe and led to approximately 5.1 million fatalities. To prevent both COVID‐19 and viral transmission, DNA‐based/RNA‐based vaccines, non‐replicating viral vector vaccines, and inactivated vaccines have been recently developed. However, a precise clinical and histological characterization of SARS‐CoV‐2 vaccine‐related dermatological manifestations is still lacking. A systematic review of 229 articles was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, in order to provide an extensive overview of SARS‐CoV‐2 vaccine‐related skin manifestations. Data on demographics, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles and summarized. A total of 5941 SARS‐CoV‐2 vaccine‐related dermatological manifestations were gathered. Local injection‐site reactions were the most frequently observed, followed by rash/unspecified cutaneous eruption, urticarial rashes, angioedema, herpes zoster, morbilliform/maculopapular/erythematous macular eruption, pityriasis rosea and pityriasis rosea‐like eruptions, and other less common dermatological manifestations. Flares of pre‐existing dermatological conditions were also reported. Cutaneous adverse reactions following SARS‐CoV‐2 vaccine administration seem to be heterogeneous, rather infrequent, and not life‐threatening. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.
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Affiliation(s)
- Gianluca Avallone
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Francesco Cavallo
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Gabriele Roccuzzo
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
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Erythema Migrans-like COVID Vaccine Arm: A Literature Review. J Clin Med 2022; 11:jcm11030797. [PMID: 35160249 PMCID: PMC8836892 DOI: 10.3390/jcm11030797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 01/24/2022] [Accepted: 01/30/2022] [Indexed: 12/24/2022] Open
Abstract
COVID Vaccine Arm (CVA) is an adverse drug reaction from mRNA vaccine for SARS-CoV-2. CVA is characterized by erythema and edema on the vaccination site (usually deltoid area) that appears from 5 to 10 days after vaccination and is sometimes associated with itching or pain. The exact etiology of CVA is still unclear, but delayed hypersensitivity against an excipient seems to play an essential role in the pathogenesis of the disease. This work performs a systematic literature review on CVA using three different databases containing articles published until 10 November 2021. The literature review includes eight papers reporting single cases or case series of CVA. Moreover, it also addresses, other cutaneous reactions following COVID 19 vaccinations as well as possible differential diagnosis. CVA migrans-like erythema is characterized by a ring-shaped rash in the injection area, which appears some days after the injection and disappears in about 10 days. This reaction may appear more rapidly in subsequent doses.
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Tozinameran. REACTIONS WEEKLY 2022. [PMCID: PMC8758367 DOI: 10.1007/s40278-022-08979-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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