A Case of Acquired Hemophilia A Following SARS-CoV-2 Infection

Hafzah, Husam; McGuire, Cara; Hamad, Amar

doi:10.7759/cureus.16579

Cited by 17 publications

(27 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, it can occur at any time if not managed appropriately [3][4][5]. AHA has been linked to autoimmune disorders, medications, tumors, lymphoproliferative cancers, and infections [6]. A thorough history of immunological disorders, medications, and the wide spectrum of related medical problems that predispose the patient to acquired hemophilia should be obtained [3].…”

Section: Introductionmentioning

confidence: 99%

Acquired Hemophilia A Post-COVID-19 Vaccination: A Case Report and Review

Hennawi¹,

Masri²,

Bakir³

et al. 2022

Cureus

View full text Add to dashboard Cite

Acquired hemophilia A (AHA) is an inhibitory coagulopathy that represents a rare variant of hemorrhagic syndromes. We present a case of idiopathic AHA in a 75-year-old male patient with a cutaneous hematoma that could be attributed to a recent COVID-19 vaccination. The aim of this report is to raise awareness of a possible association between AHA and COVID-19 vaccination and to review similar reported cases and management plans to prevent the development of possible morbidity and debilitating complications. This case illustrates an exceptionally rare side effect of the COVID-19 vaccination. The advantages of obtaining the COVID-19 vaccine outweigh the risks.

show abstract

Section: Introductionmentioning

confidence: 99%

Acquired Hemophilia A Post-COVID-19 Vaccination: A Case Report and Review

Hennawi¹,

Masri²,

Bakir³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…Case studies have reported the appearance of AHA following COVID-19 infection. [11][12][13] Our case highlights the appearance of AHA following the administration of the Pfizer-BioNTech COVID-19 vaccine in Southeast Asia. The onset of the patient's symptoms shortly after vaccination in the absence of any other precipitating factor points towards a vaccine-induced AHA.…”

Section: Case Reportmentioning

confidence: 82%

“…Details of those studies are tabulated in table 2. Case studies have reported the appearance of AHA following COVID-19 infection 11–13…”

Section: Discussionmentioning

confidence: 99%

Case of acquired haemophilia a in Southeast Asia following COVID-19 vaccine

et al. 2022

View full text Add to dashboard Cite

Acquired haemophilia A (AHA) is a rare bleeding disorder with high morbidity and mortality, but it is eminently treatable if diagnosis and treatment are prompt. We report a case of AHA in Southeast Asia following the administration of the Pfizer-BioNTech COVID-19 vaccine. A man in his 80s developed multiple bruises 2 weeks after his first dose of the COVID-19 vaccine. Diagnosis was delayed due to his cognitive impairment and low clinical suspicion. This led to a representation with worsening ecchymosis, a left thigh haematoma and symptomatic anaemia. Laboratory testing was notable for an isolated prolongation of the activated partial thromboplastin time, which remained uncorrected in the mixing test. Further testing confirmed the presence of factor VIII (FVIII) inhibitors and low FVIII titres of 6.7%. He responded to treatment with intravenous methylprednisolone and recombinant activated FVII. Screening for autoimmune diseases and malignancies was negative.

show abstract

“… 4 , 5 Despite significant research and insight gained into the mechanisms of these presumptive autoimmune cytopenic phenomena, little is known about the potential for SARS‐CoV‐2 to elicit a severe bleeding phenotype secondary to autoreactivity. 6 , 7 , 8 , 9 …”

Section: Introductionmentioning

confidence: 99%

“…Several case reports have recently described acquired coagulation factor inhibitors in the setting of SARS‐CoV‐2 infection 7 , 8 , 9 or following SARS‐CoV‐2 vaccination. 10 , 11 , 12 , 13 While few cases have been reported, determining whether these hematologic abnormalities are related to SARS‐CoV‐2 infection or vaccination, or are simply temporal associations, is important as a recent randomized controlled trial demonstrated decreased mortality with therapeutic‐dose heparin for patients admitted with COVID‐19 and elevated D‐dimers.…”

Section: Introductionmentioning

confidence: 99%

Coagulation factor inhibitors in COVID‐19: From SARS‐CoV‐2 vaccination to infection

Jacobs

Adkins

Walker

et al. 2022

Research and Practice in Thrombosis and Haemostasis

View full text Add to dashboard Cite

Background Recent reports have highlighted patients with COVID‐19 and vaccine recipients diagnosed with coagulation factor inhibitors. This is challenging. as severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection has been identified as a prothrombotic risk factor, with heparin treatment decreasing mortality. However, both infection and vaccination have been associated with immune‐mediated hematologic abnormalities, including thrombocytopenia, further rendering these groups at risk for both hemorrhagic and thrombotic events. Objectives We sought to characterize the incidence and clinical findings of coagulation factor inhibitors in patients with COVID‐19 and vaccine recipients. Methods We queried the US Centers for Disease Control and Prevention’s Vaccine Adverse Event Reporting System (VAERS), a publicly accessible database, for reports of potential bleeding episodes or coagulation disturbances associated with SARS‐CoV‐2 vaccination. We performed an additional comprehensive literature review to identify reports of SARS‐CoV‐2 infection or vaccination‐associated coagulation factor inhibitors. Results VAERS data showed 58 cases of coagulation factor inhibitors, suggesting a rate of 1.2 cases per 10 million doses. A total of 775 articles were screened and 15 were suitable for inclusion, with six reports of inhibitors after vaccination and nine reports of inhibitors after infection. Inhibitor specificity for factor VIII was most common. Among reported cases, two patients expired due to hemorrhage, one following infection and one following vaccination. Conclusion The incidence of coagulation factor inhibitors in patients with SARS‐CoV‐2 vaccination and infection appears similar to the general population. Nonetheless, given the importance of heparin therapy in treating hospital patients, recognition of inhibitors is important.

show abstract

A Case of Acquired Hemophilia A Following SARS-CoV-2 Infection

Cited by 17 publications

References 5 publications

Acquired Hemophilia A Post-COVID-19 Vaccination: A Case Report and Review

Acquired Hemophilia A Post-COVID-19 Vaccination: A Case Report and Review

Case of acquired haemophilia a in Southeast Asia following COVID-19 vaccine

Coagulation factor inhibitors in COVID‐19: From SARS‐CoV‐2 vaccination to infection

Contact Info

Product

Resources

About