Pernicious anemia following COVID-19 vaccination: A report of two cases
Abstract
Since December 2019 and the global epidemic of COVID-19 different countries have focused on vaccines, and one of the inactivated produced vaccines was the Sinopharm COVID-19 vaccine. Some side effects of this vaccine were reported previously, including pain at the vaccination site, fatigue, lethargy, headache, and tenderness, which were more prevalent among individuals <49 years old.
Herein, we reported two patients aged 45 and 51 years old. Both patients have different signs and symptoms after receiving the second dose of the vaccine. None had a history of chronic disease. On examination and following labs and other diagnostic investigations, we found megaloblastic anemia due to atrophic gastritis and low intrinsic factor. These cases showed an autoimmune side effect of the Sinopharm COVID-19 vaccine that was previously reported with an exact mechanism but other features called Covid Arm, Guillain-Barré syndrome, and thrombocytopenia. The mechanism of this reaction is unclear yet.
2. Zhang Y. Yang J, Fu Q, et al. Real-world study of the effectiveness of BBIBPCORV (SINOPHARM) Covi-19 vaccine in the Kingdom of Morocco. BMC Public Health. 2022; 22(1):1584-1586.
3. Al Kaabi N, Zhang Y, Xia S, et al. Effect of 2 Inactivated SARS-CoV-2 Vaccines on Symptomatic COVID-19 Infection in Adults: A Randomized Clinical Trial. JAMA. 2021; 326 (1): 35–45.
4. Babaee E, Amirkafi A, Tehrani-Bnaihashemi A, et al. Adverse effects following COVID-19 vaccination in Iran. BMC Infect Dis. 2022; 22(1):476.
5. Jeevandara Ch, Aberathna IS, Pushpakumara PD, et al. Persistence of immune responses to the Siopharm /BBiBP-CorV vaccine. Immun Inflamm Dis. 2022; 10(6):e621.
6. Conley CL, Green TW, Hartmann RC, et al. Prolonged treatment of pernicious anemia with vitamin B12. Am J Med. 1952; 13(3):284-93.
7. Bennett M. Megaloblastic Anaemia. J R Coll Physicians Edinb. 2020; 50(4):456-461.
8. Bizzaro N, Antico A. Diagnosis and classification of pernicious anemia. Autoimmun Rev. 2014:13(4-5): 565-8.
9. Waheed S, Bayas A, Hindi F, et al. Neurological complications of COVID-19: Guillain-Barre syndrome following Pfizer COVID-19 vaccine. Cureus. 2021; 13(2): e13426.
10. Wei N, Fishman M, Wattenberg D, et al. COVID arm: A reaction to the Moderna vaccine. JAAD Case Rep. 2021; 10:92-95.
11. Schultz NH, Sørvoll IH, Michelsen AE, et al. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med . 2021;384(22):2124-2130.
12. Kragholm K, Sessa M, Mulvad T, et al. Thrombocytopenia after COVID-19 vaccination. J Autoimmun. 2021;123:102712.
13. Gold MS, Balakrishnan MR, Amarasinge A, et al. An approach to death as an adverse event following immunization. Vaccine. 2016; 34(2):212-217.
14. Jacobson DL, Gange SJ, Rose NR, et al. Epidemiology and estimated population burden of selected autoimmune diseases in the United States. Clin Immunol Immunopathol. 1997; 84(3): 223–243.
15. Lerner A, Jeremias P, Matthias T. The world incidence and prevalence of autoimmune diseases is increasing. Int JCeliac Dis. 2015; 3(4): 151–155.
16. Wraith DC, Goldman M, Lambert PH. Vaccination and autoimmune disease, what is the evidence? Lancet. 2003; 362(9396):1659–66.
17. Albert LJ, Inman RD. Molecular mimicry and autoimmunity. N Engl J Med. 1999; 341(27):2068–2074.
18. Todd JA, Wicker LS. Genetic protection from the inflammatory disease type 1 diabetes in humans and animal models. Immunity. 2001; 15(3):387–95.
19. Duke RC. Self recognition by T cells. I. Bystander killing of target cells bearing syngeneic MHC antigens. J Exp Med. 1989;170(1):59-71.
Files | ||
Issue | Vol 17, No 3 (2023) | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/ijhoscr.v17i3.13312 | |
Keywords | ||
COVID-19 Vaccination Pernicious anemia |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |