Drug-induced IgA vasculitis in children and adults: Revisiting drug causality using a dual pharmacovigilance-based approach

IgA vasculitis in adult patient following vaccination by ChadOx1 nCoV-19

“…We read with great interest the article by Rasmussen et al [ 1 ] identifying signals of drugs associated with Immunoglobulin A (IgA) vasculitis (IgAV), a rare immune complex small-vessel vasculitis [ [2] , [3] , [4] ]. The authors used data from the French pharmacovigilance database and from Vigibase®, the WHO global individual case safety reports database [ 5 ], with descriptive and disproportionality approaches.…”

“…In this study, the most common drug class associated with IgAV was vaccines. All types of vaccines were concerned (live attenuated vaccines, inactivated vaccines and subunit vaccines) [ 1 ].…”

“…Several factors have been described, like bacterial and viral infections [ 6 ], malignancies and drugs, mostly vaccines as reported by Rasmussen et al [ 1 ]. In their study, the median time from vaccination to IgAV onset was 11 days (interquartile range: 6–30 days) [ 1 ]. Our patient had no possible other cause of IgAV than the ChadOx1 nCoV-19 vaccine.…”

An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient

“…In addition, several genes, most commonly involving the human leukocyte antigen system, have been identified that cause certain individuals to be more susceptible for disease development [ 1 ]. In regards to drug-induced IgA vasculitis, vaccines are the most common trigger representing about 23.6% of those cases [ 9 ]. Other groups of drugs suspected to have induced IgA vasculitis include antibiotics, TNF-α blockers, anti-hypertensives, analgesics, anticoagulant, antiplatelet agents, and nonsteroidal anti-inflammatory drugs (NSAIDs) [ 9 ].…”

“…In regards to drug-induced IgA vasculitis, vaccines are the most common trigger representing about 23.6% of those cases [ 9 ]. Other groups of drugs suspected to have induced IgA vasculitis include antibiotics, TNF-α blockers, anti-hypertensives, analgesics, anticoagulant, antiplatelet agents, and nonsteroidal anti-inflammatory drugs (NSAIDs) [ 9 ]. There are no clear data on the prevalence of drug-induced IgA vasculitis given the assessment of drug causality is challenging as there are many other etiological factors involved, the lack of prospective studies and also no specific laboratory markers to discriminate between drug induced and non-drug induced vasculitis [ 4 , 5 ].…”