接种 BNT162b2 mRNA（辉瑞-生物科技）疫苗后出现慢性自发性荨麻疹，以预防 SARS-CoV-2。
Chronic spontaneous urticaria after BNT162b2 mRNA (Pfizer-BioNTech) vaccination against SARS-CoV-2.
机构信息
From the Leumit Research Institute and Department of Family Medicine, Leumit Health Services, Ashkelon, Israel.
出版信息
Allergy Asthma Proc. 2022 Jan 1;43(1):30-36. doi: 10.2500/aap.2022.43.210111.
The factors that trigger and exacerbate chronic spontaneous urticaria (CSU) are well known, but it is not unclear whether messenger RNA (mRNA) vaccination against severe acute respiratory syndrome coronavirus 2 can trigger new cases of CSU or a relapse of CSU after long-term remission. To study the clinical cases of patients with new-onset CSU and CSU in remission who relapsed within 3 months after BNT162b2 mRNA vaccination. All patients with a CSU diagnosis within 12 weeks of BNT162b2 mRNA vaccination were retrospectively identified and included in the new-onset CSU and the relapsed CSU groups. The first control group (CSU control group) retrospectively consisted of patients diagnosed with CSU in complete clinical remission for ≥ 6 months, with no CSU relapse after vaccination. The second control group (healthy control group) consisted of subjects who were fully vaccinated and without CSU, matched 1:2 for age and sex with patients with CSU. Twenty-seven patients were included in the relapsed CSU group, 32 patients in the new-onset CSU group, 179 patients in the CSU control group, and 476 subjects in the healthy control group. The relapsed CSU and new-onset CSU groups had more allergic comorbidities overall (19 [70.4%] and 13 [40.6%], respectively) than the CSU control group and the healthy control group (50 [27.9%] and 110 [23.1%], respectively; p < 0.001). Multiple logistic regression analysis showed that a positive autologous serum skin test result, overall allergic comorbidities, and basopenia were positively associated with the probability of CSU relapse within 3 months after BNT162b2 mRNA vaccination (odds ratio [OR] 5.54 [95% confidence interval {CI}, 2.36-13.02], p < 0.001); OR 6.13 [95% CI, 2.52-14.89], p = 0.001; and OR 2.81 [95% CI, 1.17-6.72, p = 0.020, respectively). It is possible that BNT162b2 mRNA vaccination serves as a provoking and/or relapsing factor of CSU in individuals with allergic diseases and/or predisposed autoimmunity.
慢性自发性荨麻疹（CSU）的触发和加重因素众所周知，但尚不清楚信使 RNA（mRNA）疫苗接种严重急性呼吸综合征冠状病毒 2 是否会引发新的 CSU 病例，或在长期缓解后复发 CSU。研究对象为 BNT162b2mRNA 疫苗接种后 3 个月内新发 CSU 和缓解后复发 CSU 的患者。所有在 BNT162b2mRNA 疫苗接种后 12 周内诊断为 CSU 的患者均被回顾性识别，并纳入新发 CSU 和复发 CSU 组。第一个对照组（CSU 对照组）为回顾性诊断为 CSU 并完全缓解至少 6 个月的患者，接种疫苗后无 CSU 复发。第二个对照组（健康对照组）由完全接种疫苗且无 CSU 的受试者组成，按年龄和性别与 CSU 患者 1:2 匹配。新发 CSU 组纳入 32 例患者，复发 CSU 组纳入 27 例患者，CSU 对照组纳入 179 例患者，健康对照组纳入 476 例患者。与 CSU 对照组和健康对照组相比，复发 CSU 组和新发 CSU 组的过敏合并症总体更多（分别为 19[70.4%]和 13[40.6%]）（分别为 50[27.9%]和 110[23.1%]；p<0.001）。多因素逻辑回归分析显示，自体血清皮肤试验阳性、总体过敏合并症和血小板减少与 BNT162b2mRNA 疫苗接种后 3 个月内 CSU 复发的概率呈正相关（比值比[OR]5.54[95%置信区间{CI}，2.36-13.02]，p<0.001）；OR 6.13[95%CI，2.52-14.89]，p=0.001；OR 2.81[95%CI，1.17-6.72]，p=0.020）。在有过敏疾病和/或自身免疫倾向的个体中，BNT162b2mRNA 疫苗接种可能是 CSU 的触发和/或复发因素。
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