Non-episodic angioedema with eosinophilia after BNT162b2 mRNA COVID-19 vaccination

Ishizuka, Kosuke; Katayama, Kohta; Kaji, Yuki; Tawara, Junsuke; Ohira, Yoshiyuki

doi:10.1093/qjmed/hcab245

Cited by 15 publications

(15 citation statements)

References 5 publications

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“… 18 Reports of adverse reactions from COVID-19 vaccines are increasing. In some studies, eosinophilia or eosinophilic reactions were reported, 19 20 21 but some of them were from other forms of the vaccine, not the mRNA vaccine, 22 23 and there were no cases of eosinophilic gastroenteritis. The relationship between COVID-19 vaccines and EGE is not yet clearly understood.…”

Section: Discussionmentioning

confidence: 99%

mRNA COVID-19 Vaccine-Associated Subserosal Eosinophilic Gastroenteritis: A Case Report

Lee

2022

J Korean Med Sci

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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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Section: Discussionmentioning

confidence: 99%

mRNA COVID-19 Vaccine-Associated Subserosal Eosinophilic Gastroenteritis: A Case Report

Lee

2022

J Korean Med Sci

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“…Although the exact pathogenesis of NEAE is unknown, the fact that it is more common among women and occurs after infection or drug exposure suggests that NEAE is the result of an abnormal immune response to various exogenous stimuli in genetically susceptible individuals, with sex hormones likely playing a role [ 3 ] . Eosinophilic disease after COVID-19 infection has been reported, namely eosinophilic pneumonia and eosinophilic granulomatosis with polyangiitis [ 4 , 5 ] . In addition, there have been reports of NEAE after vaccination against SARS-CoV-2 [ 6 ] .…”

Section: Discussionmentioning

confidence: 99%

Non-Episodic Angioedema Associated with Eosinophilia after COVID-19

Harada

Kosaka

Nakai

2022

European Journal of Case Reports in Internal Medicine

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ntroduction: Non-episodic angioedema associated with eosinophilia (NEAE) has been reported primarily in young East Asian women and is characterized by a single episode of persistent limb oedema, peripheral eosinophilia, and transient joint pain. Although there are reports of eosinophilia disease after coronavirus disease 2019 (COVID-19), the occurrence of NEAE has not been previously reported. Case description: A 29-year-old Japanese woman, with a history of allergic rhinitis and atopic dermatitis, sought a medical consultation for persisting oedema of the extremities, which developed about 2 weeks after she contracted COVID-19. Physical examination revealed symmetrical non-pitting oedema with peripheral predominance. Laboratory examination revealed a blood eosinophil count of 7536/µl. The patient was diagnosed with NEAE and a 7-day course of prednisolone (15 mg/day) was initiated, with rapid improvement in the oedema and no recurrence on follow-up. Discussion: The exact aetiology of NEAE is unknown, but it may develop after infection or drug exposure. Eosinophilic disease after COVID-19 infection has been reported and, therefore, eosinophilic angioedema should be considered in the differential diagnosis of non-pitting oedema of the extremities after a COVID-19 infection. Early diagnosis of NEAE is important as rapid improvement can be achieved with low-dose steroid treatment. Conclusion: NEAE can develop after COVID-19 and should be considered in the differential diagnosis of non-pitting oedema of the extremities.

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“…Alopecia areata (AA) [74], bullous pemphigoid [75], COVID arm (local injection site reaction) [76,77], eosinophilic cellulitis (Wells syndrome) [22], eosinophilic panniculitis [24], erythema multiforme [78], herpes zoster (skin, oral and facial palsy) [53,57,79,80], leukocytoclastic vasculitis [81], non-episodic angioedema with eosinophilia [23], psoriasis [82], Stevens-Johnson syndrome [83], subacute cutaneous lupus erythematosus [11,84,85], and urticaria [77] have been reported following COVID-19 vaccination (Table 1). AA is an autoimmune disease, and an increase in IFN-γ and inflammatory cytokines, including IL-6 and IL-1β, have been reported [86].…”

Section: Skin Diseasesmentioning

confidence: 99%

“…Eosinophilia may also be responsible for post-vaccine adverse reactions. Eosinophilic myocarditis, eosinophilic pneumonia, EGPA (relapse), eosinophilic cellulitis, eosinophilic panniculitis, and non-episodic angioedema with eosinophilia have been reported following COVID-19 vaccination [20][21][22][23][24][25]. SARS-CoV-1 vaccines have also been shown to induce eosinophilia in the lungs of mice [114].…”

Section: Eosinophiliamentioning

confidence: 99%

“…Inflammatory cytokines release [7][8][9][10], autoimmunity involvement [11][12][13][14][15][16][17][18][19], eosinophil association [20][21][22][23][24][25], and angiotensin-converting enzyme 2 (ACE2) downregulation [26,27] Vaccines 2022, 10, 866 2 of 13 have been suggested as contributing etiologies of post-vaccine adverse reactions. Inflammatory cytokines, including interleukin (IL)-6 and IL-1β, are released due to lipid nanoparticles (LNPs) within the mRNA vaccine [9].…”

Section: Introductionmentioning

confidence: 99%

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What Should We Do after the COVID-19 Vaccination? Vaccine-Associated Diseases and Precautionary Measures against Adverse Reactions

et al. 2022

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COVID-19 vaccines have been used to counteract the global COVID-19 pandemic. While these are effective, adverse reactions have been reported, such as injection-site pain, muscle ache, fever, palpitation, and chest discomfort. The release of inflammatory cytokines, such as interleukin (IL)-6 and IL-1β, is a potential mechanism for post-vaccine side-effects. Chest discomfort after the vaccination, including myocarditis and acute coronary syndrome, is a particularly serious adverse reaction. It is important to be familiar with the differential diagnoses of chest discomfort and organ-specific diseases associated with COVID-19 vaccines as the preparation for booster shots and vaccinations among children aged 5–11 years begins. High-intensity exercise, alcohol, tobacco smoking, and baths promote inflammatory cytokines, such as IL-6, which may exacerbate the adverse reactions after vaccination. Japanese data show that deaths during baths are the most common for several days after mRNA vaccination. Additionally, alcohol and tobacco smoking were identified as predictive factors of lower antibody titers after vaccination. In this review, we aimed to provide a few recommendations to prevent vaccine-associated disease.

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Non-episodic angioedema with eosinophilia after BNT162b2 mRNA COVID-19 vaccination

Cited by 15 publications

References 5 publications

mRNA COVID-19 Vaccine-Associated Subserosal Eosinophilic Gastroenteritis: A Case Report

mRNA COVID-19 Vaccine-Associated Subserosal Eosinophilic Gastroenteritis: A Case Report

Non-Episodic Angioedema Associated with Eosinophilia after COVID-19

What Should We Do after the COVID-19 Vaccination? Vaccine-Associated Diseases and Precautionary Measures against Adverse Reactions

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