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- Published on: 3 April 2022
- Published on: 3 April 2022Other examples of COVID-19-related vasculitis
oscar,m jolobe, retired geriatrician, British Medical Association
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April 03, 2022
The occurrence of Henoch-Schonlein purpura after vaccination against COVID-19 infection(1) is, to a certain extent, predictable, given the fact that other subtypes of vasculitis have been reported after vaccination against this pathogen(2)(3). In one instance the temporal artery was involved, and the histological findings comprised infiltration with multinucleated giant cells, histiocytes, lymphocytes, and eosinophils. The patient had presented with bilateral headache, fever, fatigue, and myalgia, 2 days after receiving the second dose of a COVID-mRNA vaccine(2). In the second example granulomatous vasculitis involving the kidney occurred after administration of the AstraZeneca vaccine(3).
Even on its own, without the mediation of a vaccine, COVID-19 infection can trigger the occurrence of vasculitis(4). In the latter example a 71 year old woman presented with cough, fever, malaise and a pruritic rash on both legs, 2 weeks after her husband had been hospitalised for COVID-19 infection. The rash consisted of purpuric macules and papules , extending from ankles to the thighs. Histology revealed small-vessel vasculitis characterised by fibrinoid necrosis and infiltration by neutrophils.. Direct immunofluorescence revealed granular deposition of C3 within vessel walls. A nasopharyngeal swab was positive for COVID-19, using the reverse transcriptase polymerase chain reaction test(...Conflict of Interest:
None declared.