Bullous Pemphigoid Associated With COVID-19 Vaccines: An Italian Multicentre Study

Frontiers in Medicine

article

Laura Atzori¹  Emiliano Antiga²  Roberto Maglie²  Francesco Moro³  Elena Biancamaria Mariotti²  Alberto Corrಠ Sabatino Pallotta⁴  Biagio Didona⁵  Angelo Valerio Marzano⁶  Giovanni Di Zenzo³  Carlo Alberto Maronese⁶  Marzia Caproni⁸  Chiara Moltrasio⁶  Giovanni Genovese⁶  Pamela Vezzoli^1,10  Paolo Sena^1,10  Giulia Previtali^1,11  Emanuele Cozzani^1,12  Giulia Gasparini^1,12  Aurora Parodi^1,12 

[1] Dermatology Clinic, Department Medical Sciences and Public Health, University of Cagliari;Department of Health Sciences, Section of Dermatology, University of Florence;Molecular and Cell Biology Laboratory, Istituto Dermopatico dell'Immacolata - Istituto di Ricovero e Cura a Carattere Scientifico;Dermatology Clinic, Istituto Dermopatico dell'Immacolata - Istituto di Ricovero e Cura a Carattere Scientifico;Rare Disease Unit, Istituto Dermopatico dell'Immacolata - Istituto di Ricovero e Cura a Carattere Scientifico;Dermatology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico;Department of Pathophysiology and Transplantation, Università degli Studi di Milano;Rare Diseases Unit, Section of Dermatology, Department of Health Sciences, Unità Sanitaria Locale Toscana Centro, European Reference Network-Skin Member, University of Florence;Department of Medical Surgical and Health Sciences, University of Trieste;Dermatology Unit, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Hospital;Clinical Chemistry Laboratory, Department of Clinical Pathology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII Hospital;DiSSal, Dermatology Clinic, University of Genoa, San Martino Policlinic Hospital- Istituto di Ricovero e Cura a Carattere Scientifico

关键词: bullous pemphigoid;    vaccine;    COVID-19;    autoantibodies;    SARS-CoV-2;    triggering factors;    BP180;    BP230;   

DOI  :  10.3389/fmed.2022.841506

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Bullous pemphigoid (BP) is an autoimmune bullous disease caused by circulating autoantibodies toward the hemidesmosomal antigens BP180 and BP230. Cases of BP have been described following vaccinations against tetanus, poliomyelitis, diphtheria, influenza, pneumococcus, meningococcus, hepatitis B and rabies. The putative mechanism by which COVID-19-vaccines may induce BP has not been clarified. An Italian multicentre study was conducted to collect clinical, histopathological and immunopathological data of patients with BP associated with COVID-19-vaccines. Twenty-one cases were collected, including 9 females and 12 males (M/F = 1.3) with a median age at diagnosis of 82 years. Seventeen patients received the COMIRNATY Pfizer-BioNTech vaccine, two the Moderna mRNA-1273 vaccine, one the ChAdOx1/nCoV-19-AstraZeneca/ Vaxzevria vaccine and one received the first dose with the ChAdOx1/nCoV-19-AstraZeneca/Vaxzevria vaccine and the second dose with the COMIRNATY Pfizer-BioNTech vaccine. Median latency time between the first dose of anti-SARS-CoV-2 vaccine and the onset of cutaneous manifestations was 27 days. Median BPDAI at onset was 42. Eleven out of seventeen patients (65%) had positive titres for anti-BP180 antibodies with a median value of 106.3 U/mL on ELISA; in contrast, only five out of seventeen (29%) were positive for anti-BP230 antibodies, with a median of 35.3 U/mL. In conclusion, in terms of mean age, disease severity at diagnosis and clinical phenotype vaccine-associated BP patients seem to be similar to idiopathic BP with an overall benign course with appropriate treatment. On the other hand, the slight male predominance and the reduced humoral response to BP230 represent peculiar features of this subset of patients.

【 授权许可】

CC BY