Evans syndrome after BNT162b2 mRNA COVID-19 vaccination

New-onset Evans syndrome associated with systemic lupus erythematosus after BNT162b2 mRNA COVID-19 vaccination

Daisuke Hidaka 1, Reiki Ogasawara 2, Shunsuke Sugimura 2, Fumiaki Fujii 2, Keisuke Kojima 2, Jun Nagai 2, Ko Ebata 2, Kohei Okada 2, Naoki Kobayashi 2, Masahiro Ogasawara 2, Masahiro Imamura 2, Shuichi Ota 2

Affiliations 

• PMID: 34687421
 
• PMCID: PMC8536917
 
• DOI: 10.1007/s12185-021-03243-2

Free PMC article

https://pubmed.ncbi.nlm.nih.gov/34687421/

 New-onset Evans syndrome associated with systemic lupus erythematosus after #COVIDVaccination (Pfizer–BioNTech):

"This case suggests that mRNA COVID-19 vaccination may cause an autoimmune disorder."

Abstract

Evans syndrome presents as concurrent autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP). Systemic lupus erythematosus (SLE) is the most frequent autoimmune disorder associated with Evans syndrome. We herein report a case of new-onset Evans syndrome associated with SLE after BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccination in a 53-year-old woman. Blood examination at diagnosis showed hemolytic anemia with a positive Coombs test and thrombocytopenia. Hypocomplementemia and the presence of lupus anticoagulant indicated a strong association with SLE. Prednisolone administration rapidly restored hemoglobin level and platelet count. This case suggests that mRNA COVID-19 vaccination may cause an autoimmune disorder. Physicians should be aware of this adverse reaction by mRNA COVID-19 vaccination and should consider the benefits and risks of vaccination for each recipient.