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Case Reports
. 2021 Sep 16;21(1):958.
doi: 10.1186/s12879-021-06655-x.

First description of immune complex vasculitis after COVID-19 vaccination with BNT162b2: a case report

Victoria Therese Mücke  1 , Viola Knop  2 , Marcus Maximilian Mücke  2 , Falk Ochsendorf  3 , Stefan Zeuzem  2
Affiliations
Case Reports

First description of immune complex vasculitis after COVID-19 vaccination with BNT162b2: a case report

Victoria Therese Mücke et al. BMC Infect Dis. .

Abstract

Background: Cases of immune complex vasculitis have been reported following COVID-19 infections; so far none in association with novel mRNA-based COVID-19 vaccination. This case report describes a cutaneous immune complex vasculitis after vaccination with BNT162b2.

Case presentation: A 76-year old male with liver cirrhosis developed an immune complex vasculitis 12 days after the second injection of BNT162b2. On physical examination, the patient presented with pruritic purpuric macules on hands and feet, flexor and extensor parts of both legs and thighs and lower abdomen, and bloody diarrhoea. Laboratory testing showed elevated inflammatory markers. After short treatment with oral steroids all clinical manifestations and laboratory findings resolved.

Conclusions: An increasing number of clinical manifestations have been attributed to COVID-19 infection and vaccination. This is the first written report of immune complex vasculitis after vaccination with BNT162b2. We present our case report and a discussion in the light of type three hypersensitivity reaction.

Keywords: BNT162b2; COVID-19 vaccination; Case report; Immune complex vasculitis; Type three hypersensitivity.

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Conflict of interest statement

VTM: None; VK: None; MMM: None; FO: None; SZ: None.

Figures

Fig. 1
Fig. 1
A–D Symmetric distal limb swelling and palpable purpuric confluent macules on extensor (A) and flexor (B) parts of both hands, legs (C) and thighs (D). Purpuric maculae ranging from 2 mm to few centimetres by confluence
Fig. 2
Fig. 2
A, B Resolved skin lesions of extensor (A) and flexor (B) parts of both hands on the fifth day of steroid therapy
See this image and copyright information in PMC

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