Catastrophic antiphospholipid syndrome triggered by mRNA COVID-19 vaccine

Moreno-Torres, Víctor; Gutiérrez, Ángela; Valdenebro, María; Ortega, A.; Cítores, M.J.; Montero, Esther

doi:10.55563/clinexprheumatol/s3sbgu

Cited by 11 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These considerations suggest that aPLs may represent a thrombotic risk factor following COVID-19 vaccination [112]. These data could support mRNA vaccine as a trigger for APS and catastrophic antiphospholipid syndrome (CAPS), although several case reports of both conditions after SARS-CoV-2 vaccination have been published [113][114][115][116], other serie do not confirm this hypothesis [117]. In this series of high risk APS patients (triple-positive aPL confirmed 12 weeks apart), out of 161 patients interviewed, 18 (11%) had COVID-19.…”

Section: Antiphospholipid Syndrome and Covid-19 Vaccinesmentioning

confidence: 96%

COVID-19 Vaccines and Autoimmune Hematologic Disorders

et al. 2022

View full text Add to dashboard Cite

Worldwide vaccination against SARS-CoV-2 has allowed the detection of hematologic autoimmune complications. Adverse events (AEs) of this nature had been previously observed in association with other vaccines. The underlying mechanisms are not totally understood, although mimicry between viral and self-antigens plays a relevant role. It is important to remark that, although the incidence of these AEs is extremely low, their evolution may lead to life-threatening scenarios if treatment is not readily initiated. Hematologic autoimmune AEs have been associated with both mRNA and adenoviral vector-based SARS-CoV-2 vaccines. The main reported entities are secondary immune thrombocytopenia, immune thrombotic thrombocytopenic purpura, autoimmune hemolytic anemia, Evans syndrome, and a newly described disorder, so-called vaccine-induced immune thrombotic thrombocytopenia (VITT). The hallmark of VITT is the presence of anti-platelet factor 4 autoantibodies able to trigger platelet activation. Patients with VITT present with thrombocytopenia and may develop thrombosis in unusual locations such as cerebral beds. The management of hematologic autoimmune AEs does not differ significantly from that of these disorders in a non-vaccine context, thus addressing autoantibody production and bleeding/thromboembolic risk. This means that clinicians must be aware of their distinctive signs in order to diagnose them and initiate treatment as soon as possible.

show abstract

Section: Antiphospholipid Syndrome and Covid-19 Vaccinesmentioning

confidence: 96%

COVID-19 Vaccines and Autoimmune Hematologic Disorders

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Laboratory tests showed the presence of lupus anticoagulant. The patient was treated with low-dose prednisone, hydroxychloroquine, adjusted low-molecular-weight-heparin (LMWH) and thrice-weekly hemodialysis [ 93 ].…”

Section: Resultsmentioning

confidence: 99%

Insights into new-onset autoimmune diseases after COVID-19 vaccination

Guo

Liu

Chen

et al. 2023

Autoimmunity Reviews

View full text Add to dashboard Cite

“…While our patient did not meet the full criteria for CAPS, her presentation supports severe coagulopathy in the setting of known antiphospholipid syndrome, with a suspected immunologic trigger from recent COVID-19 immunization. There have been some case reports of CAPS after COVID-19 vaccination [ 24 , 25 ]. Though more research is needed to determine the immunogenicity of mRNA vaccines, it is plausible that the vaccine could have induced severe coagulopathy with concern for approaching CAPS.…”

Section: Discussionmentioning

confidence: 99%

Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome

Seeley¹,

Zimmer²,

Berghea³

2022

Cureus

View full text Add to dashboard Cite

In this report, we describe the case of a woman with suspected COVID-19 immunization-induced probable catastrophic antiphospholipid syndrome. The patient is a 35-year-old female with a past medical history significant for antiphospholipid syndrome, not on anticoagulation, who presented with a 5-day history of abdominal pain and distention, nausea, vomiting, and shortness of breath. She had received her first dose of the Pfizer COVID-19 vaccine one day prior to the onset of symptoms. After extensive workup at an outside hospital, she was found to be in acute heart failure exacerbated by severe mitral and tricuspid regurgitation. She was transferred to our hospital for escalation of care. EKG showed evidence of prior inferior and septal myocardial infarction. Transesophageal echocardiogram (TEE) showed reduced ejection fraction, severe mitral and tricuspid regurgitation, and a left ventricular thrombus. Cardiac MRI showed subendocardial late gadolinium enhancement indicative of ischemia. However, CTA of the coronary vessels showed no signs of obstruction. Therefore, her acute heart failure was thought to be due to small vessel thrombosis secondary to antiphospholipid syndrome. During admission, she had several absence seizure-like episodes. CT head showed several hypodensities of the deep white matter and brain MRI demonstrated multiple hyperintense T2 FLAIR signal foci with restriction diffusion and enhancement involving the cerebral hemisphere, consistent with subacute strokes attributed to being secondary to antiphospholipid syndrome or embolic from the left ventricular thrombus. She was treated with heparin for suspected catastrophic antiphospholipid syndrome and high-dose corticosteroid therapy for concomitant Systemic Lupus Erythematosus (SLE). She was discharged in a stable condition.

show abstract

Catastrophic antiphospholipid syndrome triggered by mRNA COVID-19 vaccine

Cited by 11 publications

References 0 publications

COVID-19 Vaccines and Autoimmune Hematologic Disorders

COVID-19 Vaccines and Autoimmune Hematologic Disorders

Insights into new-onset autoimmune diseases after COVID-19 vaccination

Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome

Contact Info

Product

Resources

About