IgA vasculitis following COVID-19 vaccination: A French multicentre case series including 12 patients.

ABSTRACT

OBJECTIVE: The worldwide COVID-19 vaccination campaign triggered several autoimmune diseases. We hereby aimed to describe IgA vasculitis (IgAV) following COVID- 19 vaccination. METHODS: We conducted a French national multi-centre, retrospective study of new onset adult IgAV diagnosis following COVID-19 vaccination. RESULTS: Twelve patients with a new onset IgAV were included. Five were women (41.6%), and the median age was 52,5 years IQR [30.75-60.5]. Ten received an mRNA vaccine. Two patients received a viral vector vaccine. The median time from vaccination to onset of symptoms was 11.5 days with an IQR of [4.25-21.25]. The vasculitis occurred after the first vaccine dose in most patients (n=8). All patients had skin involvement, with skin necrosis in four patients. Seven patients had joint involvement and 2 had arthritis. Four had non-severe gastrointestinal involvement. Two had non-severe renal involvement. Median C-reactive protein was 26 mg/l [10-66.75], median creatininaemia was 72 µmol/l [65-81], one patient had eGFR < 60 ml/min at management. All patients received a treatment, including glucocorticosteroids in 9 patients (75%). Five patients received a vaccine dose after developing IgAV, one of them experienced a minor cutaneous relapse. CONCLUSION: Baseline presentation of IgAV following COVID-19 vaccination was mild to moderate and outcomes were favourable. Thus, a complete COVID-19 vaccination regimen should be completed in this population. Of note, a fortuitous link cannot be ruled out requiring a worldwide pharmacovigilance search now to confirm these findings.