Sex: M
Vaccine: COVID19
Symptoms: Blood creatinine, Blood immunoglobulin E, Bronchoalveolar lavage, Computerised tomogram thorax, Eosinophil count
Clinical narrative: BNT162b2 mRNA vaccine related pulmonary eosinophilia; This is a literature report .  A 73-year-old male patient received BNT162b2, BNT162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "Non-smoker" (unspecified if ongoing); "eosinophilia" (unspecified if ongoing). The patient's concomitant medications were not reported. Past drug history included: Oxygen for To maintian oxygen level, notes: required 3LPM supplemental oxygen to maintain peripheral oxygen saturation (SpO2) above 94%.; Azithromycin for eosinophilia; Prednisone for eosinophilia. Vaccination history included: Bnt162b2 (DOSE 2), for COVID-19 immunisation, reaction(s): "Eosinophilic pneumonia". The following information was reported: PULMONARY EOSINOPHILIA (hospitalization, medically significant), 2 weeks after the suspect product(s) administration, outcome "unknown", described as "BNT162b2 mRNA vaccine related pulmonary eosinophilia". The event "bnt162b2 mrna vaccine related pulmonary eosinophilia" required emergency room visit. The patient underwent the following laboratory tests and procedures: Antibody test: weakly positive, notes: (1:4 titer); Antineutrophil cytoplasmic antibody: Normal; Antinuclear antibody: Normal; Aspergillus test: Negative; Biopsy: revealed organizing pneumonia with mixed, notes: inflammatory infiltrate; Blood creatinine: elevated; Blood immunoglobulin E: Normal; Normal; Bronchoalveolar lavage: 432, notes: Unit: cells/L revealed elevated WBC with neutrophilic predominance (85%); Computerised tomogram thorax: unremarkable; revealed a 2 cm rounded ground-glass opacity in, notes: the right upper lobe; Eosinophil count: 580, notes: Unit: cells/L eosinophilia at 5%; 6814, notes: Unit: cells/L marked eosinophilia at 29.5%; FEV1/FVC ratio: 76 %; Fibrin D dimer: Negative; Forced expiratory volume: 2.80 L, notes: (88% predicted); Forced vital capacity: 3.67 L, notes: (90% predicted); anti-CCP: Normal; Negative; Normal; afebrile and audibly wheezing with a prolonged, notes: expiratory phase; Normal; Negative; Oxygen saturation: Unknown result; 93 %, notes: tachypneic on 4LPM supplemental oxygen; Procalcitonin: Negative; Pulmonary function test: Normal; Red blood cell sedimentation rate: Negative; Respiratory viral panel: Negative; White blood cell count: 13200, notes: Unit: /mL leukocytosis; 23100, notes: Unit: /mL leukocytosis. Therapeutic measures were taken as a result of pulmonary eosinophilia.  Clinical course: Patient did not had no history of respiratory symptoms, smoking, sick contacts, recent travel, chemical or biological exposures6 months after initial symptom onset, the patient received his third BNT162b2 mRNA vaccine dose. 2 weeks after vaccination, he presented to the ED with severe dyspnea, wheezing and cough with yellow sputum. He also noted a new itchy, erythematous bilateral forearm rash and painless oral ulcers. And IgE, ANA, ANCA, SS-A/B, anti-CCP, and complement levels were normal. Intravenous methylprednisolone treatment was initiated with rapid improvement in dyspnea, eosinophilia and renal function. Patient was discharged home on a prednisone taper with resolution of symptoms. Subsequent allergy work up did not indicate any apparent. etiology of hypereosinophilia. Testing for strongyloides, coccidiosis and aspergillosis were also negative. A final diagnosis of BNT162b2 mRNA vaccine related pulmonary eosinophilia was made.  No follow-up attempts are possible. No further information is expected.; Sender's Comments: Based on the information provided and temporal association, a causal relationship between BNT162b2, BNT162b2 omi ba.4-5 and the reported event pulmonary eosinophilia cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-PV202200078128 Same article/patient/drug and different event;US-PFIZER INC-PV202200078128 Same article/patient/drug and different event;