Abstract
Background: Large clinical trials have demonstrated the overall safety of vaccines for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, reports have emerged of autoimmune phenomena, including vaccine-associated myocarditis, immune thrombocytopenia, and immune thrombotic thrombocytopenia.
Case presentation: Here we present a novel case of a young woman who developed life-threatening autoimmune hemolytic anemia (AIHA) after her first dose of a SARS-CoV-2 mRNA vaccine. Notably, initial direct antiglobulin testing was negative using standard anti-IgG reagents, which are “blind” to certain immunoglobulin (IgG) isotypes. Further testing using an antiglobulin reagent that detects all IgG isotypes was strongly positive and confirmed the diagnosis of AIHA. The patient required transfusion with 13 units of red blood cells, as well as treatment with corticosteroids, rituximab, mycophenolate mofetil, and immune globulin.
Conclusion: As efforts to administer SARS-CoV-2 vaccines continue globally, clinicians must be aware of potential autoimmune sequelae of these therapies.
Keywords: SARS-CoV-2 mRNA vaccine; autoimmune hemolytic anemia; direct antiglobulin test.
【저자키워드】 SARS-CoV-2 mRNA vaccine, autoimmune hemolytic anemia, direct antiglobulin test., 【초록키워드】 Treatment, SARS-CoV-2, IgG, Vaccine, coronavirus, Corticosteroids, clinical trial, mRNA vaccine, Diagnosis, SARS-CoV-2 vaccines, severe acute respiratory syndrome Coronavirus, immune, SARS-CoV-2 vaccine, rituximab, Immunoglobulin, myocarditis, mRNA, Patient, Autoimmune, thrombocytopenia, red blood cells, transfusion, respiratory, Therapies, Immune thrombocytopenia, autoimmune hemolytic anemia, mycophenolate, immune globulin, hemolytic anemia, mycophenolate mofetil, Direct antiglobulin test, acute respiratory syndrome, Thrombotic thrombocytopenia, antiglobulin reagent, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, clinician, first dose, reagents, thrombotic, effort, life-threatening, positive, blind, IgG isotypes, anti-IgG, isotypes, antiglobulin test, initial, detect, required, demonstrated, administer, IgG isotype, 【제목키워드】 SARS-CoV-2, Autoimmune, autoimmune hemolytic anemia,