BACKGROUNDAccording to a statement by Global Advisory Committee's WHO for Vaccine Safety, the most reported reactions of Oxford/ AstraZeneca vaccine against COVID-19 (AZD1222) are mild and self-limited, with reports of very rare side effects (> 1/10,000 and < 1/1,000). In this context, the objective of the study is to report a rare case of leukocytoclastic vasculitis after SARS-CoV-2 vaccination. This pathology consists in an inflammation of small vessels, mainly venules, by the deposition of immune complexes. CASE REPORTOn April 27, 2021, a 62-year-old female patient without comorbidities, received the first dose of Oxford/AstraZeneca COVID-19 vaccine (AZD1222). Within 6 days, she developed chills, bilateral knee arthralgia concomitant with pain and ankle swelling, in addition to a burning sensation in the lower limbs and presence of palpable purpuric papules which extended to the proximal region of thighs and increased progressively. The biopsy of an irregular skin fragment from the right leg showed extravasation of red cells in the upper dermis, perivascular and superficial lymphocytic inflammatory infiltrate, and absence of malignancy in the cut planes examined. Laboratory tests showed leukocytosis (11.740/mm3) with left shift, elevated quantitative C-reactive protein (5.36 mg/dL) and high fibrinogen levels (432 mg /dL). The patient was promptly treated with prednisone 40 mg/day for 10 days with progressive tapering of the medication and fexofenadine hydrochloride 180 mg/day for 5 days. There was a good clinical evolution of the condition and after 10 days the patient had no more symptoms. There were no sequelae. Patient has not yet received the second dose. CONCLUSIONThis case has a great scientific value as it is essential for post-approval pharmacovigilance of the Oxford/AstraZeneca vaccine against COVID-19 (AZD1222) and serves as a basis for physicians to evaluate future patients with suspected leukocytoclastic vasculitis associated with COVID-19 vaccine. It should be noted that these rare adverse events associated with vaccination are of important knowledge but should not impact the great utility of vaccination and the well-documented safety profile of available vaccines.

Desde dezembro de 2019, a população mundial enfrenta um cenário de pandemia da infecção pelo vírus SARS-CoV-2 (COVID-19), na ausência de imunizantes específicos para a doença. Eventualmente, quando esses foram desenvolvidos e amplamente distribuídos pelo mundo, surgiram novas questões: as reações adversas apresentadas por essas vacinas. Em janeiro de 2021, o Brasil iniciou a aplicação de doses da vacina Oxford/AstraZeneca (AZD1222), as quais apresentaram efeitos adversos locais e sistêmicos variados. Nesse contexto, o objetivo desse estudo é relatar o caso de uma paciente do sexo feminino de 62 anos que apresentou um quadro raro de vasculite leucocitoclástica após a primeira dose do imunizante AZD 1222. A paciente foi rapidamente diagnosticada e tratada com prednisona e anti-histamínico, apresentando resolução do evento em 10 dias.