A case of acquired hemophilia A and bullous pemphigoid following SARS-CoV-2 mRNA vaccination.
J Formos Med Assoc
; 121(9): 1872-1876, 2022 Sep.
Article
in English
| MEDLINE | ID: covidwho-1983431
ABSTRACT
Acquired hemophilia is a rare disease resulting from autoantibodies against endogenous factor VIII (FVIII), which associates with bleeding and a high mortality rate. The pathophysiology is still unclear. Recent studies suggest genetic and environmental factors trigger the breakdown of immune tolerance. We report a 77-year-old Taiwanese man presented with multiple ecchymoses and some hemorrhagic blisters three weeks after SARS-CoV-2 mRNA (Moderna) vaccination. Isolated activated partial thromboplastin time (aPTT) prolongation was found. Acquired hemophilia A (AHA) was confirmed by low factor VIII (FVIII) activity and high titer of FVIII inhibitor. The pathohistology of skin biopsy further supported the concomitant diagnosis of bullous pemphigoid. To date, 6 cases of acquired hemophilia A following SARS-CoV-2 mRNA vaccination were reported worldwide. We reviewed and summarized the characteristics of these cases. We also discussed the rare finding of concomitant acquired hemophilia A and bullous pemphigoid. Bullous pemphigoid results from autoantibody against epithelial basement membrane zone of skin. In this article, we proposed possibility of SARS-CoV-2 mRNA vaccine associated autoimmunity against FVIII and epithelial basement membrane zone.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pemphigoid, Bullous
/
COVID-19
/
Hemophilia A
Type of study:
Case report
Topics:
Vaccines
Limits:
Aged
/
Humans
/
Male
Language:
English
Journal:
J Formos Med Assoc
Journal subject:
Medicine
Year:
2022
Document Type:
Article
Affiliation country:
J.jfma.2022.02.017
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