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Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination

We report a case of autoimmune bullous disease (AIBD) with IgG and IgM autoantibodies against epidermal basement membrane zone (BMZ), which showed recurrence of mucocutaneous lesions after coronavirus disease 2019 (COVID-19) mRNA vaccination. A 20-year-old Japanese woman with a 4-year history of epi...

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Autores principales: Minakawa, Satoko, Matsuzaki, Yasushi, Yao, Shogo, Sagara, Chihiro, Akasaka, Eijiro, Koga, Hiroshi, Ishii, Norito, Hashimoto, Takashi, Sawamura, Daisuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10267980/
https://www.ncbi.nlm.nih.gov/pubmed/37324140
http://dx.doi.org/10.3389/fmed.2023.1093827
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author Minakawa, Satoko
Matsuzaki, Yasushi
Yao, Shogo
Sagara, Chihiro
Akasaka, Eijiro
Koga, Hiroshi
Ishii, Norito
Hashimoto, Takashi
Sawamura, Daisuke
author_facet Minakawa, Satoko
Matsuzaki, Yasushi
Yao, Shogo
Sagara, Chihiro
Akasaka, Eijiro
Koga, Hiroshi
Ishii, Norito
Hashimoto, Takashi
Sawamura, Daisuke
author_sort Minakawa, Satoko
collection PubMed
description We report a case of autoimmune bullous disease (AIBD) with IgG and IgM autoantibodies against epidermal basement membrane zone (BMZ), which showed recurrence of mucocutaneous lesions after coronavirus disease 2019 (COVID-19) mRNA vaccination. A 20-year-old Japanese woman with a 4-year history of epidermolysis bullosa acquisita (EBA) presented to our clinic. She noticed fever and rash on the same day and visited at our hospital 2 days later. Physical examination revealed blisters, erosions and erythema on the face, shoulder, back, upper arms, and lower lip. A skin biopsy from the forehead showed subepidermal blister. Direct immunofluorescence showed linear depositions of IgG, IgM, and C3c in the epidermal BMZ. By indirect immunofluorescence of 1M NaCl-split normal human skin, circulating IgG autoantibodies were bound to the dermal side of the split at 1:40 serum dilution, and circulating IgM antibodies were bound to the epidermal side of the spilt. After the increase of prednisolone dose to 15 mg/day, the mucocutaneous lesions resolved in a week. The present case is the first case of possible EBA with IgG and IgM anti-BMZ antibodies, in which the mucocutaneous lesions were recurred after COVID-19 mRNA vaccination. Clinicians should be aware that bullous pemphigoid-like AIBDs, including EBA and IgM pemphigoid, might be developed after COVID-19 mRNA vaccination.
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spelling pubmed-102679802023-06-15 Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination Minakawa, Satoko Matsuzaki, Yasushi Yao, Shogo Sagara, Chihiro Akasaka, Eijiro Koga, Hiroshi Ishii, Norito Hashimoto, Takashi Sawamura, Daisuke Front Med (Lausanne) Medicine We report a case of autoimmune bullous disease (AIBD) with IgG and IgM autoantibodies against epidermal basement membrane zone (BMZ), which showed recurrence of mucocutaneous lesions after coronavirus disease 2019 (COVID-19) mRNA vaccination. A 20-year-old Japanese woman with a 4-year history of epidermolysis bullosa acquisita (EBA) presented to our clinic. She noticed fever and rash on the same day and visited at our hospital 2 days later. Physical examination revealed blisters, erosions and erythema on the face, shoulder, back, upper arms, and lower lip. A skin biopsy from the forehead showed subepidermal blister. Direct immunofluorescence showed linear depositions of IgG, IgM, and C3c in the epidermal BMZ. By indirect immunofluorescence of 1M NaCl-split normal human skin, circulating IgG autoantibodies were bound to the dermal side of the split at 1:40 serum dilution, and circulating IgM antibodies were bound to the epidermal side of the spilt. After the increase of prednisolone dose to 15 mg/day, the mucocutaneous lesions resolved in a week. The present case is the first case of possible EBA with IgG and IgM anti-BMZ antibodies, in which the mucocutaneous lesions were recurred after COVID-19 mRNA vaccination. Clinicians should be aware that bullous pemphigoid-like AIBDs, including EBA and IgM pemphigoid, might be developed after COVID-19 mRNA vaccination. Frontiers Media S.A. 2023-05-30 /pmc/articles/PMC10267980/ /pubmed/37324140 http://dx.doi.org/10.3389/fmed.2023.1093827 Text en Copyright © 2023 Minakawa, Matsuzaki, Yao, Sagara, Akasaka, Koga, Ishii, Hashimoto and Sawamura. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Medicine
Minakawa, Satoko
Matsuzaki, Yasushi
Yao, Shogo
Sagara, Chihiro
Akasaka, Eijiro
Koga, Hiroshi
Ishii, Norito
Hashimoto, Takashi
Sawamura, Daisuke
Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination
title Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination
title_full Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination
title_fullStr Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination
title_full_unstemmed Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination
title_short Case report: A case of epidermolysis bullosa acquisita with IgG and IgM anti-basement membrane zone antibodies relapsed after COVID-19 mRNA vaccination
title_sort case report: a case of epidermolysis bullosa acquisita with igg and igm anti-basement membrane zone antibodies relapsed after covid-19 mrna vaccination
topic Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10267980/
https://www.ncbi.nlm.nih.gov/pubmed/37324140
http://dx.doi.org/10.3389/fmed.2023.1093827
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