Acquired hemophilia following COVID‐19 vaccination: Case report and review of literature

Happaerts, Michiel; Vanassche, Thomas

doi:10.1002/rth2.12785

Cited by 12 publications

(7 citation statements)

References 24 publications

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“…The reason why our patient developed AHA is not clear. In the last few years, cases of AHA in COVID patients have been described, both after infection and vaccination [15][16][17][18][19][20][21][22][23][24][25]. A few cases of AHA following the viral infection have been reported in literature [15,[26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

Hematological Complications in a COVID-19 Patient: A Case Report

Ianuà,

Caldarelli,

De Matteis

et al. 2023

Diseases

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Hemophilia A is a hemorrhagic disorder caused by insufficient or inadequate coagulation factor VIII activity. Two different forms are described: congenital, hereditary X-linked, and acquired. Acquired hemophilia A (AHA) is a rare condition and it is defined by the production of autoantibodies neutralizing factor VIII, known as inhibitors. We report the case of a 72-year-old man with a clinical diagnosis of AHA after SARS-CoV-2 infection, which has been described in association with several hematological complications. SARS-CoV-2 infection could represent the immunological trigger for the development of autoantibodies. In our patient, SARS-CoV-2 infection preceded the hemorrhagic complications by 15 days. This lag time is in line with the other cases reported and compatible with the development of an intense immune response with autoantibody production. It is possible that since our patient was affected by type 1 diabetes mellitus, he was more prone to an immune system pathological response against self-antigens. A prompt, appropriate therapeutic intervention with activated recombinant factor VII administration and cyclophosphamide has led to rapid remission of clinical and laboratory findings.

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Section: Discussionmentioning

confidence: 99%

Hematological Complications in a COVID-19 Patient: A Case Report

Ianuà,

Caldarelli,

De Matteis

et al. 2023

Diseases

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“…In the flare group, the information regarding other potential triggers was unavailable in most studies. Nevertheless, two patients had a history of COVID-19 infection prior to receiving the COVID-19 vaccines, and subsequently experienced a BP eruption [99,103].…”

Section: Other Potential Non-vaccine Triggersmentioning

confidence: 99%

“…Additional corticosteroid therapy was used in most patients experiencing a flare of AIBD, with further immunosuppressants utilized for treatment-resistant cases [14,18,32,106]. Rituximab was administered in six cases, resulting in four cases experiencing disease improvement; one case died 15 days after the administration of COVID-19 vaccination due to sepsis, and one case had ongoing treatment and no final outcome was reported [51,99,105,[108][109][110]. The majority of cases showed improvement (65%) or resolution (22%) after treatment, with resolution times ranging from 1 to 10 weeks.…”

Section: Treatment and Outcomes For New-onset Aibd Or Aibd Flaresmentioning

confidence: 99%

New Onset and Exacerbation of Autoimmune Bullous Dermatosis Following COVID-19 Vaccination: A Systematic Review

Wu,

Huang,

Wang

et al. 2024

Vaccines

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Background: Cases of autoimmune bullous dermatosis (AIBD) have been reported following COVID-19 vaccination. Objective: We aimed to provide an overview of clinical characteristics, treatments, and outcomes of AIBDs following COVID-19 vaccination. Methods: We conducted a systematic review and searched the Embase, Cochrane Library, and Medline databases from their inception to 27 March 2024. We included all studies reporting ≥ 1 patient who developed new-onset AIBD or experienced flare of AIBD following at least one dose of any COVID-19 vaccine. Results: We included 98 studies with 229 patients in the new-onset group and 216 in the flare group. Among the new-onset cases, bullous pemphigoid (BP) was the most frequently reported subtype. Notably, mRNA vaccines were commonly associated with the development of AIBD. Regarding the flare group, pemphigus was the most frequently reported subtype, with the mRNA vaccines being the predominant vaccine type. The onset of AIBD ranged from 1 to 123 days post-vaccination, with most patients displaying favorable outcomes and showing improvement or resolution from 1 week to 8 months after treatment initiation. Conclusions: Both new-onset AIBD and exacerbation of pre-existing AIBD may occur following COVID-19 vaccination. Healthcare practitioners should be alert, and post-vaccination monitoring may be essential.

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“…A specific mention deserves attention, being recently identified acquired hemophilia A following coronavirus disease 2019 (COVID-19) vaccination. Although a causality link between vaccine and acquired hemophilia A has not been definitely ascertained, several of such cases have already been reported [ 29 , 30 , 31 , 32 , 33 ]. A possible explanation is that vaccines may foster or boost immune reactions, followed by insurgence of new autoimmune events or exacerbation of pre-existing but latent immune dysregulations, which can ultimately drive the clonal selection of B cells producing specific autoantibodies, including those against FVIII.…”

Section: Autoimmune Disorders Leading To Bleedingmentioning

confidence: 99%

Autoimmune Diseases Affecting Hemostasis: A Narrative Review

Favaloro

Pasalic

Lippi

2022

IJMS

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Hemostasis reflects a homeostatic mechanism that aims to balance out pro-coagulant and anti-coagulant forces to maintain blood flow within the circulation. Simplistically, a relative excess of procoagulant forces can lead to thrombosis, and a relative excess of anticoagulant forces can lead to bleeding. There are a wide variety of congenital disorders associated with bleeding or thrombosis. In addition, there exist a vast array of autoimmune diseases that can also lead to either bleeding or thrombosis. For example, autoantibodies generated against clotting factors can lead to bleeding, of which acquired hemophilia A is the most common. As another example, autoimmune-mediated antibodies against phospholipids can generate a prothrombotic milieu in a condition known as antiphospholipid (antibody) syndrome (APS). Moreover, there exist various autoimmunity promoting environments that can lead to a variety of antibodies that affect hemostasis. Coronavirus disease 2019 (COVID-19) represents perhaps the contemporary example of such a state, with potential development of a kaleidoscope of such antibodies that primarily drive thrombosis, but may also lead to bleeding on rarer occasions. We provide here a narrative review to discuss the interaction between various autoimmune diseases and hemostasis.

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Acquired hemophilia following COVID‐19 vaccination: Case report and review of literature

Cited by 12 publications

References 24 publications

Hematological Complications in a COVID-19 Patient: A Case Report

Hematological Complications in a COVID-19 Patient: A Case Report

New Onset and Exacerbation of Autoimmune Bullous Dermatosis Following COVID-19 Vaccination: A Systematic Review

Autoimmune Diseases Affecting Hemostasis: A Narrative Review

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