Mencarelli, L.; Moi, L.; Dewarrat, N.; Monti, M.; Alberio, L.; Ringwald, M.; Swierdzewska, K.; Panagiotis, A.; Ribi, C. Eosinophilic Granulomatosis with Polyangiitis after mRNA-1273 SARS-CoV-2 Vaccine. Vaccines2023, 11, 1335.
Mencarelli, L.; Moi, L.; Dewarrat, N.; Monti, M.; Alberio, L.; Ringwald, M.; Swierdzewska, K.; Panagiotis, A.; Ribi, C. Eosinophilic Granulomatosis with Polyangiitis after mRNA-1273 SARS-CoV-2 Vaccine. Vaccines 2023, 11, 1335.
Mencarelli, L.; Moi, L.; Dewarrat, N.; Monti, M.; Alberio, L.; Ringwald, M.; Swierdzewska, K.; Panagiotis, A.; Ribi, C. Eosinophilic Granulomatosis with Polyangiitis after mRNA-1273 SARS-CoV-2 Vaccine. Vaccines2023, 11, 1335.
Mencarelli, L.; Moi, L.; Dewarrat, N.; Monti, M.; Alberio, L.; Ringwald, M.; Swierdzewska, K.; Panagiotis, A.; Ribi, C. Eosinophilic Granulomatosis with Polyangiitis after mRNA-1273 SARS-CoV-2 Vaccine. Vaccines 2023, 11, 1335.
Abstract
During one of the worst global health crises, millions of people were vaccinated against SARS-CoV-2. In rare cases, new onset systemic inflammatory diseases were reported with temporal coincidence to the vaccination. We describe a case of severe Eosinophilic Granulomatosis with Polyangiitis (EGPA) in a young asthmatic woman, occurring after a 2nd dose of mRNA-1273 vaccine. She presented with multisystem EGPA with cardiac and central nervous system involve-ment, complicated by secondary immune thrombocytopenia (ITP). We review the reported cases of EGPA coinciding with SARS-CoV-2 mRNA vaccination. All potentially vaccine-related EGPA cases reported so far occurred within 14 days from immunization.
EGPA is very rare with an incidence of 1:1’000’000 inhabitants and the number of reported post-vaccination EGPA cases lies within the expected incidence rate for the period.
While we cannot prove a causal relationship between the vaccine and EGPA onset, the temporal relationship with the vaccine immune stimulation is intriguing, in a disease occurring almost always in adults with asthma and/or chronic rhinosinusitis and driven by an aberrant Th2 lym-phocyte activation with hypereosinophilia.
Nevertheless, cases of inflammatory diseases emerging in the context of vaccination remain rare and the benefits of preventing severe Covid presentations with SARS-CoV-2 mRNA vaccines remains unquestionable.
Keywords
Eosinophilic Granulomatosis with Polyangiitis; SARS-CoV-2 mRNA vaccine; immune thrombocytopenia
Subject
Medicine and Pharmacology, Immunology and Allergy
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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