Calabria Elena, Canfora Federica, Mascolo Massimo, Varricchio Silvia, Mignogna Michele Davide, Adamo Daniela
Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, via Pansini 5, 80131 Naples, Italy.
Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, via Pansini 5, 80131 Naples, Italy.
Pathol Res Pract. 2022 Apr;232:153834. doi: 10.1016/j.prp.2022.153834. Epub 2022 Mar 5.
Cases of severe autoimmune blistering diseases (AIBDs) have recently been reported in association with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination.
To describe a report of oropharyngeal Pemphigus Vulgaris (OPV) triggered by the mRNABNT162b2 vaccine (Comirnaty®/ Pfizer/ BioNTech) and to analyze the clinical and immunological characteristics of the AIBDs cases reported following the SARS-CoV-2 vaccination.
The clinical and immunological features of our case of OPV were documented. A review of the literature was conducted and only cases of AIBDs arising after the SARS-CoV-2 vaccination were included.
A 60-year old female patients developed oropharyngeal and nasal bullous lesions seven days after the administration of a second dose of the mRNABNT162b2 vaccine (Comirnaty®/ Pfizer/BioNtech). According to the histology and direct immunofluorescence findings showing the presence of supra-basal blister and intercellular staining of IgG antibodies and the presence of a high level of anti-Dsg-3 antibodies (80 U/ml; normal < 7 U/ml) in the serum of the patients, a diagnosis of oropharyngeal Pemphigus Vulgaris was made.
A total of 35 AIBDs cases triggered by the SARS-CoV-2 vaccination were found (including our report). 26 (74.3%) were diagnosed as Bullous Pemphigoid, 2 (5.7%) as Linear IgA Bullous Dermatosis, 6 (17.1%) as Pemphigus Vulgaris and 1 (2.9%) as Pemphigus Foliaceus. The mean age of the sample was 72.8 years and there was a predominance of males over females (F:M=1:1.7). In 22 (62.9%) cases, the disease developed after Pfizer vaccine administration, 6 (17.1%) after Moderna, 3 (8.6%) after AstraZeneca, 3 (8.6%) after CoronaVac (one was not specified). All patients were treated with topical and/or systemic corticosteroids, with or without the addition of immunosuppressive drugs, with a good clinical response in every case.
Clinicians should be aware of the potential, though rare, occurrence of AIBDs as a possible adverse event after the SARS-CoV-2 vaccination. However, notwithstanding, they should encourage their patients to obtain the vaccination in order to assist the public health systems to overcome the COVID-19 pandemic.
近期有报告称严重自身免疫性大疱性疾病（AIBDs）与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）疫苗接种有关。
描述1例由mRNA BNT162b2疫苗（Comirnaty®/辉瑞/生物科技公司）引发的口腔寻常型天疱疮（OPV）病例报告，并分析SARS-CoV-2疫苗接种后报告的AIBDs病例的临床和免疫学特征。
记录我们的OPV病例的临床和免疫学特征。进行文献综述，仅纳入SARS-CoV-2疫苗接种后出现的AIBDs病例。
一名60岁女性患者在接种第二剂mRNA BNT162b2疫苗（Comirnaty®/辉瑞/生物科技公司）7天后出现口腔和鼻腔大疱性病变。根据组织学和直接免疫荧光检查结果显示存在基底上疱以及IgG抗体的细胞间染色，且患者血清中抗桥粒芯糖蛋白3抗体水平较高（80 U/ml；正常<7 U/ml），诊断为口腔寻常型天疱疮。
共发现35例由SARS-CoV-2疫苗接种引发的AIBDs病例（包括我们的报告）。26例（74.3%）被诊断为大疱性类天疱疮，2例（5.7%）为线状IgA大疱性皮病，6例（17.1%）为寻常型天疱疮，1例（2.9%）为落叶型天疱疮。样本的平均年龄为72.8岁，男性多于女性（女：男=1：1.7）。22例（62.9%）病例在接种辉瑞疫苗后发病，6例（17.1%）在接种Moderna疫苗后发病，3例（8.6%）在接种阿斯利康疫苗后发病，3例（8.6%）在接种科兴疫苗后发病（1例未注明）。所有患者均接受了局部和/或全身糖皮质激素治疗，加用或未加用免疫抑制药物，所有病例临床反应良好。
临床医生应意识到AIBDs作为SARS-CoV-2疫苗接种后可能出现的不良事件，尽管罕见。然而，尽管如此，他们仍应鼓励患者接种疫苗，以协助公共卫生系统战胜COVID-19大流行。
Zotero 插件