{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T21:52:36Z","timestamp":1767909156941,"version":"3.49.0"},"reference-count":21,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,3,19]],"date-time":"2023-03-19T00:00:00Z","timestamp":1679184000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Although an increasing number of real-life data confirm large-scale clinical trial findings on the efficacy and safety of SARS-CoV-2 vaccines, rare but severe adverse reactions have begun to emerge. Here, we report a full-blown hypereosinophilic syndrome (HES) following a BNT162b2 (BioNTech\/Pfizer) vaccine. A 48-year-old man developed, 5 days after the first shot of the SARS-CoV-2 vaccine, erythematous and painful nodular lesions in the lower and upper limbs accompanied by widespread itching, acrocyanosis with gangrenous lesions at the tips of the first and fourth fingers of the right hand, as well as paresthesia in the right hand and foot. Investigations revealed isolated eosinophilia, occlusion of the right ulnar artery, and electromyography alteration compatible with multifocal sensory neuropathy, as well as minimal accentuation of the interstitial texture with some ground glass appearance. Despite treatment with prednisone in combination with warfarin, he developed thrombosis of the left ulnar artery. Therefore, therapy with an IL-5 inhibitor and acetylsalicylic was successfully added. Given the time interval between the onset of clinical manifestations and the vaccine shot, we believe that the mRNA vaccine triggered the eosinophilic response. This case evidences a possible link between HES and the SARS-CoV-2 vaccination. Mepolizumab, an IL-5 inhibitor, might be considered in steroid refractory cases.<\/jats:p>","DOI":"10.3390\/jcm12062376","type":"journal-article","created":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T03:09:37Z","timestamp":1679281777000},"page":"2376","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hypereosinophilic Syndrome Following the BNT162b2 (BioNTech\/Pfizer) Vaccine Successfully Treated with Mepolizumab: A Case Report and Review of the Literature"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7741-6432","authenticated-orcid":false,"given":"Ariela","family":"Hoxha","sequence":"first","affiliation":[{"name":"General Internal Medicine, Hemorrhagic and Thrombosis Unit, Department of Medicine, University of Padua, 35128 Padua, Italy"},{"name":"Internal Medicine Unit, Department of Medicine, San Bortolo Hospital, 36100 Vicenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania","family":"Tomaselli","sequence":"additional","affiliation":[{"name":"Internal Medicine Unit, Department of Medicine, San Bortolo Hospital, 36100 Vicenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giacomo Maria","family":"Minicucci","sequence":"additional","affiliation":[{"name":"Neurology Unit, San Bortolo Hospital, 36100 Vicenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacopo","family":"Dall\u2019Acqua","sequence":"additional","affiliation":[{"name":"Radiology Unit, San Bortolo Hospital, 36100 Vicenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Zardo","sequence":"additional","affiliation":[{"name":"Department of Pathology, San Bortolo Hospital, 36100 Vicenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6744-383X","authenticated-orcid":false,"given":"Paolo","family":"Simioni","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Hemorrhagic and Thrombosis Unit, Department of Medicine, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Naldi","sequence":"additional","affiliation":[{"name":"Dermatology Unit, San Bortolo Hospital, 36100 Vicenza, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,19]]},"reference":[{"key":"ref_1","unstructured":"(2023, January 31). 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