Systemic lupus erythematosus with acrocyanosis after AstraZeneca COVID‐19 vaccination

At the clinic, laboratory investigations revealed neutropenia (total white blood cell count 3850/mm3), elevation of D-dimer (0.65 mg/L fibrinogen equivalent unit), reduced protein S level (46%), and positive anti-nuclear antibodies (titer 1:160). According to the classification criteria from Europea...

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Bibliographic Details
Published in:The Kaohsiung journal of medical sciences 2022-12, Vol.38 (12), p.1230-1231
Main Authors: Wang, Huei‐Jing, Sun, Yng, Lan, Cheng‐Che Eric
Format: Article
Language:English
Subjects:
Adenoviruses
Biopsy
Blood cell count
Conflicts of interest
Coronaviruses
Correspondence
COVID-19 - prevention & control
COVID-19 vaccines
COVID-19 Vaccines - adverse effects
Cyanosis
DNA vaccines
Humans
Laboratories
Lupus
Lupus Erythematosus, Systemic - drug therapy
Pharmaceutical industry
Rheumatology
RNA
Systemic lupus erythematosus
Thrombosis
Vaccination
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Summary:At the clinic, laboratory investigations revealed neutropenia (total white blood cell count 3850/mm3), elevation of D-dimer (0.65 mg/L fibrinogen equivalent unit), reduced protein S level (46%), and positive anti-nuclear antibodies (titer 1:160). According to the classification criteria from European Alliance of Associations for Rheumatology/American College of Rheumatology (EULAR/ACR), a diagnosis of systemic lupus erythematosus (SLE) manifest with acrocyanosis was made (a score of 12). RNA virus and RNA vaccines may trigger Toll-like receptors (TLR) 7/8, inducing type 1 interferons production. 3 Similar effects are also noted with DNA virus and DNA virus-derived vaccine, via TLR9 and cyclic GMP-AMP (cGAS) and the cyclic GMP-AMP receptor stimulator of interferon genes (STING) pathway. 4 To date, only one other report demonstrated a possible causality with adenovirus-based DNA vaccine and SLE. 5 In summary, we present a case of newly onset of SLE after receiving adenovirus-based DNA COVID-19 vaccine.
ISSN:1607-551X
2410-8650
DOI:10.1002/kjm2.12630