Evans Syndrome Probably Secondary to BNT162b2 SARS-CoV-2 Vaccine: Case Report
DOI:
https://doi.org/10.60591/crspmi.170Keywords:
Anemia, Hemolytic, Autoimmune/chemically induced, BNT162 Vaccine, COVID-19 VaccinesAbstract
Evans syndrome is a rare condition. There are few case
reports of Evans syndrome following SARS-CoV-2 mRNA
vaccine, none in Portugal.
An eighteen-year-old male patient was admitted with
abdominal pain, jaundice, dark urine, and fatigue. The evaluation performed was consistent with warm autoimmune hemolytic anemia, but he later developed autoimmune thrombocytopenia. His medical history was notable for IgA vasculitis at the age of 20 months and SARS--CoV-2 mRNA vaccination nine days before admission. Viral infections, autoimmune/lymphoproliferative diseases, immunodeficiencies, medications and thrombophilia were excluded. Although he did not initially respond to corticosteroids or immunoglobulin, he responded favorably to rituximab and cyclophosphamide.
Given the temporal association and the exclusion of other
causes, we can assume Evans syndrome probably secondary to SARS-CoV-2 mRNA vaccine. It is the first case in Portugal and describes a rare idiosyncrasy. It should not discourage vaccination at the population level.
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Copyright (c) 2024 Inês Silva, Ryan Costa Silva, Inês Sopa, Catarina Gregório, Lígia Peixoto
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