Journal
VACCINES
Volume 11, Issue 8, Pages -Publisher
MDPI
DOI: 10.3390/vaccines11081335
Keywords
eosinophilic granulomatosis with polyangiitis; SARS-CoV-2; mRNA vaccine; immune thrombocytopenia
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This article describes a rare case of Eosinophilic Granulomatosis with Polyangiitis (EGPA) occurring after the mRNA-1273 vaccine in a young asthmatic woman. The temporal relationship between vaccination and EGPA onset is intriguing, although a causal relationship cannot be proven. Cases of inflammatory diseases in the context of vaccination remain rare.
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 second dose of the mRNA-1273 vaccine. She presented with multisystem EGPA with cardiac and central nervous system involvement, 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 lymphocyte activation with hypereosinophilia; nevertheless, cases of inflammatory diseases (IMIDs) emerging in the context of vaccination remain rare and the benefits of preventing severe COVID presentations with SARS-CoV-2 mRNA vaccines remain unquestionable.
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