alexa Anti-laminin-332 mucous membrane pemphigoid developing after a diphtheria tetanus vaccination.
Clinical Research

Clinical Research

Journal of Clinical Case Reports

Author(s): Sezin T, Egozi E, Hillou W, AvitanHersh E, Bergman R

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Abstract IMPORTANCE: Bullous pemphigoid (BP) has been previously described to develop after vaccination in 26 patients. Immunoblotting or enzyme-linked immunosorbent assays (ELISAs), which were performed for 7 of these patients, have always shown circulating autoantibodies against BP180 and/or BP230 antigens. A case of anti-laminin-332 mucous membrane pemphigoid (MMP) that developed shortly after a diphtheria tetanus vaccination is described, with a review of the literature on postvaccination BP. OBSERVATIONS: A 29-year-old man developed an acute eruption of oral and cutaneous blisters and erosions 2 days after receiving a diphtheria tetanus vaccination. The histopathological, immunohistochemical, immunofluorescent, ELISA, and immunoblotting assay results were compatible with anti-laminin-332 MMP. The serum autoantibodies reacted with the α3 and β3 subunits of laminin-332. The disease was controlled by administering a combination of glucocorticosteroids and dapsone. CONCLUSIONS AND RELEVANCE: The development of acute MMP shortly after a diphtheria tetanus vaccination may have been serendipitous, a result of a nonspecific bystander activation of the immune system, or due to structural mimicry between domains of the toxoid molecule and a subunit of laminin-332. This article was published in JAMA Dermatol and referenced in Journal of Clinical Case Reports

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