A case of acquired hemophilia A and bullous pemphigoid following SARS-CoV-2 mRNA vaccination

被引：14

作者：

Fu, Pei-An ^{[1
]}

Chen, Chien-Wei ^{[2
]}

Hsu, Ya-Ting ^{[3
]}

Wei, Kai-Che ^{[4
]}

Lin, Peng-Chan ^{[5
]}

Chen, Tsai-Yun ^{[3
,6
]}

机构：

[1] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Internal Med, Tainan, Taiwan

[2] Kaohsiung Vet Gen Hosp, Educ Ctr, Kaohsiung, Taiwan

[3] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Internal Med, Tainan, Taiwan

[4] Kaohsiung Vet Gen Hosp, Dept Dermatol, Kaohsiung, Taiwan

[5] Natl Cheng Kung Univ, Natl Cheng Kung Univ Hosp, Coll Med, Dept Oncol, Tainan, Taiwan

[6] 138 Sheng Li Rd, Tainan 704, Taiwan

来源：

JOURNAL OF THE FORMOSAN MEDICAL ASSOCIATION | 2022年 / 121卷 / 09期

关键词：

Acquired hemophilia A; SARS-CoV-2; mRNA vaccine; Bullous pemphigoid;

D O I：

10.1016/j.jfma.2022.02.017

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 ecchy-moses and some hemorrhagic blisters three weeks after SARS-CoV-2 mRNA (Moderna) vaccina-tion. 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 inhib-itor. 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 autoimmu-nity against FVIII and epithelial basement membrane zone.Copyright (c) 2022, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

引用

页码：1872 / 1876

页数：5