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[Acquired hemophilia A following BNT162b2 mRNA COVID-19 vaccination]

Ayami Senda1, Hideaki Saito1,2, Shinsuke Kusakabe1

  • 1Department of Hematology and Oncology, Osaka University.

[Rinsho Ketsueki] the Japanese Journal of Clinical Hematology
|February 12, 2023
PubMed

Acquired hemophilia A (AHA) is a rare disease characteized by bleeding symptoms caused by decreased factor VIII activity due to the appearance of inhibitors to factor VIII triggered by malignancy or collagen disease. An 86-year-old woman developed purpura on her extremities after the first dose of the BNT162b2 mRNA COVID-19 vaccine. This symptom subsided after a few days. After the second dose of the BNT162b2 mRNA COVID-19 vaccine, purpura appeared again, and the patient was referred to our hospital Her APTT was remarkably prolonged to 110 seconds, and a cross-mixing test revealed an inhibitor pattern. Since FVIII activity was <1% and FVIII inhibitor was 51.6 BU, she was diagnosed with AHA. Prednisolone therapy was started, and coagulative complete remission was achieved. Because acquired hemophilia can develop after mRNA COVID-19 vaccination, as in this case, it is critical to monitor the appearance of bleeding symptom.

Keywords:
Acquired hemophilia A (AHA)BNT162b2mRNA COVID-19 vaccine

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