دورية أكاديمية
أعرض في EDS

Severe refractory warm autoimmune haemolytic anaemia after the SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA) managed with emergency splenectomy and complement inhibition with eculizumab.

التفاصيل البيبلوغرافية
العنوان: Severe refractory warm autoimmune haemolytic anaemia after the SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA) managed with emergency splenectomy and complement inhibition with eculizumab.
المؤلفون: Jackson EM; Clinical School, University of Cambridge, Cambridge, UK., Harper S; Hepatopancreaticobiliary Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Webb GJ; Department of hepatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK., Thomas W; Department of haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK w.thomas1@nhs.net.
المصدر: BMJ case reports [BMJ Case Rep] 2022 Aug 31; Vol. 15 (8). Date of Electronic Publication: 2022 Aug 31.
نوع المنشور: Case Reports; Journal Article
اللغة: English
بيانات الدورية: Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101526291 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-790X (Electronic) Linking ISSN: 1757790X NLM ISO Abbreviation: BMJ Case Rep Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BMJ Pub. Group
مواضيع طبية MeSH: Anemia, Hemolytic, Autoimmune*/complications , BNT162 Vaccine*/administration & dosage , BNT162 Vaccine*/adverse effects , COVID-19*/prevention & control, Adolescent ; Antibodies, Monoclonal, Humanized ; Bilirubin ; COVID-19 Vaccines/adverse effects ; Complement Inactivating Agents/therapeutic use ; Hemoglobins ; Hemolysis ; Humans ; Immunologic Factors/therapeutic use ; Lactate Dehydrogenases ; Male ; RNA, Messenger/therapeutic use ; Rituximab/therapeutic use ; SARS-CoV-2 ; Splenectomy/adverse effects
مستخلص: A male in his teens with a history of liver transplant for biliary atresia (aged 2 years) and autoimmune haemolytic anaemia (AIHA, aged 6 years) presented with jaundice, dark urine, fatigue and chest discomfort that began 48 hours after the first dose of SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA). Investigations revealed a warm AIHA picture. Over 4 weeks the patient developed life-threatening anaemia culminating in haemoglobin of 35 g/L (after transfusion), lactate dehydrogenase of 1293 units/L and bilirubin of 228 µmol/L, refractory to standard treatment with corticosteroids and rituximab. An emergency splenectomy was performed that slowed haemolysis but did not completely ameliorate it. Eculizumab, a terminal complement pathway inhibitor, was initiated to arrest intravascular haemolysis and showed a favourable response. AIHA is rare but described after the SARS-CoV-2 Pfizer-BioNTech vaccine. This case highlights the rare complication of AIHA, the use of emergency splenectomy for disease control, and the use of eculizumab.
Competing Interests: Competing interests: WT has received speakers fees from Pfizer, Bayer, Takeda, CSL Behring, Alexion, Portola, Sanofi, Sobi, NovoNordisk and advisory board fees from Daiichi Sankyo, Ablynx, Sanofi, Takeda, Grifols, LFB Biopharmaceuticals and Takeda. EJ, GW and SH have no competing interests.
(© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.)
References: Br J Haematol. 2017 Feb;176(3):395-411. (PMID: 28005293)
Case Rep Hematol. 2016;2016:9181698. (PMID: 27092282)
Transfus Med Hemother. 2015 Sep;42(5):287-93. (PMID: 26696796)
Blood. 2014 Nov 6;124(19):2930-6. (PMID: 25232059)
Transfus Med Rev. 2019 Oct;33(4):256-265. (PMID: 31703946)
Lancet Haematol. 2017 Apr;4(4):e157-e164. (PMID: 28259520)
N Engl J Med. 2021 Oct 7;385(15):1407-1419. (PMID: 34614331)
Mediterr J Hematol Infect Dis. 2020 Jul 01;12(1):e2020053. (PMID: 32670531)
Int J Lab Hematol. 2022 Feb;44(1):e10-e12. (PMID: 34258873)
Chin Med J (Engl). 1999 Sep;112(9):805-8. (PMID: 11717950)
Ann Hematol. 2020 Jul;99(7):1679-1680. (PMID: 32542444)
Am J Hematol. 2021 Aug 1;96(8):E288-E291. (PMID: 33939851)
Br J Haematol. 2020 Jul;190(1):31-32. (PMID: 32369626)
Am J Hematol. 2015 Jan;90(1):78-81. (PMID: 24942207)
Blood. 2020 Oct 29;136(18):2080-2089. (PMID: 32877502)
JAMA. 2005 Apr 6;293(13):1653-62. (PMID: 15811985)
Dis Markers. 2015;2015:635670. (PMID: 26819490)
N Engl J Med. 2006 Sep 21;355(12):1233-43. (PMID: 16990386)
Clin Case Rep. 2020 Aug 17;8(12):2641-2644. (PMID: 33363796)
Front Immunol. 2020 Jun 03;11:946. (PMID: 32655543)
Br J Haematol. 2020 Jul;190(1):29-31. (PMID: 32374906)
Biomed Res Int. 2015;2015:363278. (PMID: 25705656)
N Engl J Med. 2013 Jun 6;368(23):2169-81. (PMID: 23738544)
BMJ Case Rep. 2018 Dec 13;11(1):. (PMID: 30567234)
فهرسة مساهمة: Keywords: Haematology (incl blood transfusion); Transplantation
المشرفين على المادة: 0 (Antibodies, Monoclonal, Humanized)
0 (COVID-19 Vaccines)
0 (Complement Inactivating Agents)
0 (Hemoglobins)
0 (Immunologic Factors)
0 (RNA, Messenger)
4F4X42SYQ6 (Rituximab)
A3ULP0F556 (eculizumab)
EC 1.1.- (Lactate Dehydrogenases)
N38TVC63NU (BNT162 Vaccine)
RFM9X3LJ49 (Bilirubin)
تواريخ الأحداث: Date Created: 20220915 Date Completed: 20220919 Latest Revision: 20220920
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC9438040
DOI: 10.1136/bcr-2022-250774
PMID: 36107725
قاعدة البيانات: MEDLINE
الوصف
تدمد:1757-790X
DOI:10.1136/bcr-2022-250774