IgA Vasculitis Following COVID-19 Vaccination: A French Multicenter Case Series Including 12 Patients

Abstract

ObjectiveThe worldwide COVID-19 vaccination campaign triggered several autoimmune diseases. We hereby aimed to describe IgA vasculitis (IgAV) following COVID- 19 vaccination.MethodsWe conducted a French national multi-centre, retrospective study of new onset adult IgAV diagnosis following COVID-19 vaccination.ResultsTwelve 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.ConclusionBaseline 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.

COVID-19 Vaccination as a Trigger of IgA Vasculitis: Truth or Illusion?

“…We read with great interest the recent article by Ramdani and colleagues in The Journal of Rheumatology on a nationwide multicenter, retrospective study conducted in France describing the status of the occurrence of IgA vasculitis (IgAV) after coronavirus disease 2019 (COVID-19) vaccination. 1 We support and appreciate the authors' work and agree with their conclusions that IgA vasculitis following COVID-19 vaccination is usually benign and that a fortuitous link cannot be ruled out and now requires a worldwide pharmacovigilance study, but there are some concerns about some of the details in the article.…”

“…First, at the beginning of the results, the authors mentioned that 14 patients were included from 12 centers; of these, 5 were women (41.6%). 1 The median age was 52.5 years (IQR 30.75-60.5). 1 There is an error here: it should be 12 patients included in the study, not 14 patients.…”

“…1 The median age was 52.5 years (IQR 30.75-60.5). 1 There is an error here: it should be 12 patients included in the study, not 14 patients.…”

“…Third, we agree with the explanation expressed by the authors in the article regarding the causal relationship between IgAV and vaccines. 1 The authors describe that the incidence of IgAV may have decreased since the beginning of the COVID-19 pandemic. 1 Both the lockdown measures and the systematic mask-wearing in many countries may have led to a decrease in the incidence of IgAV induced by other pathogens.…”

“…1 The authors describe that the incidence of IgAV may have decreased since the beginning of the COVID-19 pandemic. 1 Both the lockdown measures and the systematic mask-wearing in many countries may have led to a decrease in the incidence of IgAV induced by other pathogens. 1 However, it is important to note that one cannot ignore the influence of the season when looking at the decrease in IgAV incidence.…”