Rare Case of Acquired Hemophilia A Developed After COVID-19 Vaccine

Strategic Insights -

A 39-year-old woman in Doha, Qatar, presented to the emergency department with sudden onset gross hematuria 10 days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. The patient's coagulation profile revealed isolated prolongation of the activated partial thromboplastin time due to FVIII deficiency with normal von Willebrand factor and activity. Further analysis identified a time-dependent inhibitor pattern that was successively identified as directed against FVIII using the Nijmegen-modified Bethesda assay. The research concluded that this rare case highlights the importance of considering screening for an inhibitor in cases with otherwise unexplained onset hemorrhagic disorder and/or isolated activated partial thromboplastin time prolongation.

Key Takeaways:

  • The patient was a 39-year-old single female who presented to the emergency department with sudden onset gross hematuria 10 days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine.
  • The patient's coagulation profile revealed isolated prolongation of the activated partial thromboplastin time due to FVIII deficiency with normal von Willebrand factor and activity.
  • The mixing study revealed a time-dependent inhibitor pattern that was successively identified as directed against FVIII using the Nijmegen-modified Bethesda assay.
  • The FVIII inhibitor was detected in a titer of 17.2 Bethesda Units/mL.
  • This case is one of a couple of cases of acquired hemophilia developed after receiving mRNA-derived COVID-19 vaccines, highlighting the importance of raising awareness about this rare side effect.
  • The research recommends considering screening for an inhibitor in cases with otherwise unexplained onset hemorrhagic disorder and/or isolated activated partial thromboplastin time prolongation.

Statistics:

  • The patient's age: 39 years
  • Time between last COVID-19 vaccine dose and presentation: 10 days
  • von Willebrand factor activity: normal
  • FVIII inhibitor titer: 17.2 Bethesda Units/mL
  • Number of cases of acquired hemophilia developed after COVID-19 vaccination reported: at least two

Sources:

  • [1] Acquired Hemophilia A Developed Post COVID-19 Vaccine: An Extremely Rare Complication. Journal of Medical Cases, 2022;13(1):1-4.
  • Hamad Medical Corporation Reports Findings in COVID-19 (Acquired Hemophilia A Developed Post COVID-19 Vaccine: An Extremely Rare Complication). Asia Business Newsweekly. March 15, 2022; p 1.
  • NewsRx LLC.