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

J Rheumatol. 2023 Feb;50(2):252-257. doi: 10.3899/jrheum.220545. Epub 2022 Nov 1.

Abstract

Objective: The worldwide coronavirus disease 2019 (COVID-19) vaccination campaign triggered several autoimmune diseases. We hereby aimed to describe IgA vasculitis (IgAV) following COVID-19 vaccination.

Methods: We conducted a national, multicenter, retrospective study in France of new-onset adult IgAV diagnosis following COVID-19 vaccination.

Results: In total, 12 patients with new-onset IgAV were included. Of these, 5 (41.7%) were women, and the median age was 52.5 (IQR 30.75-60.5) years. Of the 12 patients, 10 had received an mRNA vaccine and 2 had received a viral vector vaccine. The median time from vaccination to onset of symptoms was 11.5 (IQR 4.25-21.25) days. Vasculitis occurred after the first vaccine dose in most patients (n = 8). All patients had skin involvement, with skin necrosis in 4 patients. In total, 7 patients had joint involvement and 2 had arthritis. A total of 4 patients had nonsevere gastrointestinal involvement and 2 had nonsevere renal involvement. The median C-reactive protein level was 26 (IQR 10-66.75) mg/L, the median creatininemia level was 72 (IQR 65-81) μmol/L, and 1 patient had an estimated glomerular filtration rate of less than 60 mL/min at management. All patients received treatment, including 9 patients (75%) who received glucocorticoids. In total, 5 patients received a vaccine dose after developing IgAV, 1 of whom experienced a minor cutaneous relapse.

Conclusion: The baseline presentation of IgAV following COVID-19 vaccination was mild to moderate, and outcomes were favorable. 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 to confirm these findings.

Keywords: COVID-19 vaccine; Henoch-Schönlein purpura; IgA vasculitis.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • Female
  • Humans
  • IgA Vasculitis*
  • Immunoglobulin A
  • Male
  • Middle Aged
  • Retrospective Studies
  • Vaccination / adverse effects
  • Vaccines* / therapeutic use

Substances

  • COVID-19 Vaccines
  • Immunoglobulin A
  • Vaccines