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. 2022 Jan 4;5:100140. doi: 10.1016/j.jtauto.2022.100140

Table 1.

Reported cases of autoimmunity diseases related to COVID -19 vaccination.

Author Autoimmune disease Type of vaccine Time of appearance Laboratory findings
Iremli et al. [35] Subacute Thyroiditis Sinovac – Coronavac vaccine Case 1: 4 days after 2 doses Case 1:
TSH 0.473 mIU/L, fT4 14.1 pmol/L
Case 2: 4 days after 1 dose Negative TPO, Tg and TRAB autoantibodies
CRP 100.5 mg/dL
Case 3: 7 days after 2 doses ESR 53 mm/hr
Thyroid USG bilateral focal hypoechoic areas with decreased blood flow
Case 2:
TSH 0.01 mIU/L, fT4 5.2 pmol/L,
Negative TPO, Tg and TRAB autoantibodies
CRP 6 mg/dL, ESR 19mm/hr
Thyroid USG bilateral focal hypoechoic areas with decreased blood flow
Case 3:
TSH 0.9 mIU/L, fT4 13.85 pmol/L,
Negative TPO, Tg and TRAB autoantibodies
CRP 2.4 mg/dL, ESR 25 mm/hr
Thyroid USG bilateral hypoechoic areas with decreased blood flow
Rubinstein et al. [63] Flare Graves' disease: Thyroid eye disease Pfizer- BioNTech mRNA vaccine 3 days after 2 doses Normal TSH, T4, and free T3,
Elevated thyroid stimulating immunoglobulin
ANA 1:320.
Orbit CT scan enlarged inferior and medial recti
muscles without tendon involvement or sinus
Disease
Lui et al. [49] Graves' disease Pfizer- BioNTech mRNA vaccine 5 weeks after 2 doses TSH <0.02 mIU/L, fT4 66.6 pmol/L, fT3 30.50
pmol/L
Thyroid stimulating immunoglobulin level 420%
Positive TPO and Tg
Kim et al. [51] Immune Thrombocytopenia AstraZeneca ChAdOx1 nCoV-19 vaccine 2 days after 1 dose Hemoglobin 14.0 g/dL, white blood cell count
7500/μL, platelet count 4000/μL.
Peripheral blood smear: isolated marked
thrombocytopenia without schistocytes.
Normal clotting times
Negative hepatitis B virus surface antigen, anti-
hepatitis C virus antibody, VIH, ANAS, dsDNA and
urea breath test.
Negative anti-heparin/platelet factor 4 IgG
Chittal et al. [50] Thrombotic Thrombocytopenia Moderna mRNA-1273 COVID-19 3 days after 2 dose Platelet count 65,000 platelets/mcL with further
decline to 29,000 platelets/mcL
Mildly elevated aPTT
Positive lupus anticoagulant
Positive anti-Platelet factor 4
Jawed et al. [36] Flare acute immune thrombocytopenia Pfizer- BioNTech mRNA vaccine 18 Days after the first dose
Platelet count 1000/mcL
Peripheral smear thrombocytopenia and normal red blood cell morphology
Reticulocyte count 2.2%
Prothrombin time 16.2 secs
INR 1.5 mg/dL, LDH 310 U/L
Negative ANAs
Gaignard et al. [37] Acute immune thrombocytopenia Moderna mRNA-1273 COVID-19 Case 1 (IPT): 3 days after 1 dose Case 1:
Platelet count 3000/mcL
Autoimmune hemolytic anemia Hemoglobin 15.1g/dL
Case 2 (AIHA): 5 days after 1 dose White cells count 6.600/L
Case 2:
Hemoglobin 8.6g/dL, reticulocyte count 310 × 109/L, white cells count 11.700/L, platelets count 344000/mcL
Elevated transaminases, LDH and bilirubin and decreased haptoglobin
MPO, p-ANCA, and c-ANCA negative
IAT, IgG- and C3- DAT Positive
Gadi et al. [38] Autoimmune Hemolytic Anemia Moderna mRNA-1273 COVID-19 7 days after 1 dose Hemoglobin 7.1 g/dL, MCV 93 fL, reticulocyte count 15.5%,
Total bilirubin 3.7 mg/dL, direct bilirubin 0.8 mg/dL
Haptoglobin <8 mg/dL, LDH 746 U/L
DAT was negative for IgG and C3d. However, eluate prepared from the patient's red blood cell was reactive against all test lockups
Aoun et al. [46] Cold agglutinin disease Pfizer- BioNTech mRNA vaccine 3 days after 1 dose Hemoglobin of 57 g/L, 10% reticulocytes
LDH 671 iu/l
Total bilirubin 46.4 lmol/l and direct bilirubin 12.5 lmol/l
Peripheral blood film showed marked agglutination
Direct antiglobulin test - positive for C3.
Negative ANAS, cytomegalovirus, Epstein–Barr virus, HIV, parvovirus, mycoplasma
Negative flow cytometric immunophenotyping and protein electrophoresis
Tabata et al. [45] Aplastic Anemia Pfizer- BioNTech mRNA vaccine 4 days after 2 doses White blood cell count 1.6 × 109/L and platelet count 11 × 109/l
Positive IgG cytomegalovirus and Epstein-Barr - not indicative of virus reactivation
Negative hepatitis B, hepatitis C, and VIH
Bone marrow biopsy: a hypocellular marrow
An et al. [39] Reactive arthritis Sinovac – Coronavac vaccine 3 days after 1 dose ESR 32 mm/h, CRP 15.0 mg/L
Synovial fluid analysis: leukocytes were 20–25/HP, neutrophils 90%, lymphocytes 4%, monocytes 6%, no crystals.
Negative gram stain, Negative bacterial cultures
Negative ANAs, RF, anti-CCP antibody, and HLA-B27
Mücke et al. [40] Immune complex vasculitis Pfizer- BioNTech mRNA vaccine 12 days after 2 doses ESR 42 mm/h, CRP 8.69 mg/dL, IL-6104 pg/mL
IgG 1549 mg/dL
C3 87mg/dL, C4 16.1 mg/L
Positive ANAs 1:80, and negative c-ANCA, and p-ANCA
Maye et al. [47] Flare IgA vasculitis Pfizer- BioNTech mRNA vaccine 24 hours before dose Urinalysis: red cell count of 165 cells/mm3, urinary albumin to creatinine ratio of 4.9 mg/mmol.
Serum creatinine 112μmol/L
Normal serum urea and electrolytes
Elevated IgA titres at 3.10 g/L
Negative ANAS, ANCA, and rheumatoid factor. Viral antibody titres were negative - acute or chronic infection.
Leber et al. [41] Acute Thyroiditis and Bilateral Optic Neuritis Sinovac – Coronavac vaccine 12 hours after 2 doses Positive TPO and Tg antibodies
Negative ANAs, RF, anti-dsDNA, ENAs, C3/C4, ACE IgA, IgG, IgM and anticardiolipin IgM and IgG antibodies, reactive MOG-IgG (1/320 dilution)
TSH 13.2 mUI/L, and normal levels of fT4
Nasuelli et al. [12] Guillain-Barré syndrome AstraZeneca ChAdOx1 nCoV-19 vaccine 10 days after 1 dose Electromyography compatible with demyelinating motor polyneuropathy
Lumbar puncture + CSF with normal white blood cell count and glycorrhachia
Negative Anti-GM1 IgG-IgM, GQIb IgG-IgM, GM2 IgG-IgM, anti MAG, and anti-GAD
Tagliaferri et al. [42] Myasthenia Gravis Crisis Moderna mRNA-1273 COVID-19 7 days after 2 doses Authors did not performed autoantibodies
Ghielmetti et al. [25] Acute autoimmune-like hepatitis Moderna mRNA-1273 COVID-19 7 days after de 1 dose Hemoglobin 14.8 g/dL, white cell count 6.300/L
Platelets 309000/L
INR 1.16, GOT 1127 U/L, GPT 1038 U/L,
GGT 536 U/L, ALP 192 U/L, Total bilirubin 204.8 μmoL/l
Hepatotropic virus infections profile negative
IgG 19.96 g/L
Positive ANAs (1:640, fine speckled pattern), anti-gastric parietal cells, Anti-β-2 glycoprotein IgA, and atypical AMA antibodies
Negative anti-β-2 glycoprotein IgM and IgG
ASMA, ANCA, SLA, anti-LKM1, anti-LC1, U1-snRNP, SSA/Ro, SS-B/La, CENP-B, Scl-70, Jo-1, Sm, dsDNA, Fibrillarin, RNA Polymerase III, Rib-P, PM-Scl, PCNA, and Mi-2
HLA DRB1*01:01 11:01, HLA DQA1*01:01 05:01, and HLA DQB1*03:01 05:01
Avci et al. [48] Autoimmune hepatitis Pfizer- BioNTech mRNA vaccine 30 days after doses Total bilirubin 11.8 mg/dL, direct bilirubin 9.18 mg/dL
GPT 455 IU/ml, GOT 913 IU/ml, GGT 292 IU/ml, ALP 436 IU/ml
Hemoglobin 13.3 g/dL, white cell counts 8.530/L
Platelets 1999000/mm3
ANAS 1/100
ASMA 1/100
IgG 4260 mg/dL
Hepatotropic virus infections profile negative
Normal ceruloplasmin and serum copper levels.
Londoño et al. [24] Autoimmune hepatitis Moderna mRNA-1273 COVID-19 After 1 dose GOT 993 IU/L, GPT 1312 IU/L, GGT 209 IU/L
Total bilirubin 2.3 mg/dL (peak of 8.5 mg/dL)
ALP 190 IU/L
Positive ANAs (1:80), ASMA (1:40), anti-SLA, anti-LC1
Liver ultrasound was normal.
Rela et al. [8] Autoimmune hepatitis AstraZeneca ChAdOx1 nCoV-19 vaccine Case 1: 8 days after 1 dose Case 1:
Bilirubin of 14.9 mg/dL, GPT 1025 IU/L
Case 2: 16 after 1 dose GOT 1101 IU/L, INR 2.96
Positive ANAs (1:80 - speckled pattern)
Negative ANCAs, SLA, ASMA, LKM-1 antibodies
Case 2:
Total bilirubin 19.2 mg/dL, GOT 1361 IU/L, GPT 1094 IU/L
Negative ANAs, ANCAs, ASMA, LKM-1 antibodies
Rocco et al. [30] Autoimmune hepatitis Pfizer- BioNTech mRNA vaccine 7 days after 2 doses Total Bilirubin 10.5 mg/dL, direct Bilirubin 7.5 mg/dL, ALP 243 IU/L, GGT 524 IU/L, GOT 1401 IU/L, GPT 1186 IU/L
Positive ANAs (1:160 - speckled pattern)
Negative ASMA, AMA, and anti-LKM-1
Total IgG 3500 mg/dL
Patil et al. [52] Systemic lupus erythematosus AstraZeneca ChAdOx1 nCoV-19 vaccine 14 days after 1 dose Hemoglobin 9.3 g/dL, hematocrit 26.8%, MCV 73.2, white cells count 4640/mm3, neutrophils 60%, lymphocytes 32.9%, platelets count 134000/mcL
CRP 2.8 mg/L, ESR 92 mm/h
ANAS 1:320
Positive antigen for dsDNA, nucleosomes, histones, and AMA m2.
Elevated IgG, IgM, IgA
Coombs test weakly positive.
Urinalysis: 1+ albuminuria and 3–4 RBC per high power field.
Chest X-ray was normal.
McShane et al. [28] Autoimmune hepatitis Moderna mRNA-1273 COVID-19 4 days after 1 dose Bilirubin 270 μmol/L, GOT 217U/L, GPT 1067U/L
Positive ASMA antibodies
Total IgG 21.77g/L
Vuille-Lessard et al. [26] Autoimmune hepatitis Moderna mRNA-1273 COVID-19 2 days after 1 dose Total bilirubin 65 μmol/L, GOT 811 U/L, GPT 579 U/L, ALP 124 U/L, GGT 361 U/L, INR 1.23
Albumin 28 g/L
IgG 39.4 g/L
Positive ANAs (1:1280), and ASMA
Negative Anti-AMA-M2, anti-LKM and anti-LSA antibodies
Bril et al. [31] Autoimmune hepatitis Pfizer- BioNTech mRNA vaccine 7 days after 1 dose Bilirubin 4.8 mg/dL, GOT 754 U/L, GPT 2001 U/L
ALP 170 U/L
Positive ANAs/1:1280- homogeneous pattern) and dsDNA autoantibodies.
Negative AMA, ASMA, LKM-1, and ANCAs
Total IgG 1081 mg/dL
Tun et al. [27] Autoimmune hepatitis Moderna mRNA-1273 COVID-19 3 days after 1 dose Bilirrubin 190 μmol/L, GPT 1048 U/L, GOT 229 U/L
Albumin 41 g/L
IgG 25.1 g/L, IgM 2.2 g/L, Positive ANAs
Garrido et al. [29] Autoimmune hepatitis Moderna mRNA-1273 COVID-19 15 days after 1 dose Total bilirubin 1.14 mg/dL GOT 1056U/L, GPT 1092U/L, GGT 329U/L, ALP 24U/L
ANAS 1:100 speckled pattern
Elevated IgG
Negative AMA, ASMA, LKM, SLA, ANCA
Hepatotropic virus infections profile negative
Clayton-Chubb et al. [34] Autoimmune hepatitis AstraZeneca ChAdOx1 nCoV-19 vaccine 26 days after 1 dose Bilirubin 17 lmol/L, GPT 1774 U/L, GOT 633 U/L, GGT 136 U/L, ALP 118 U/L
Albumin 45 g/L, INR 1.1.
ANAS 1:160 speckled pattern
IgG normal
Negative LKM, ASMA, AMA, SLA
Hepatotropic virus infections profile negative
Palla et al. [32] Autoimmune hepatitis Pfizer- BioNTech mRNA vaccine 30 days after 2 dose Serum transaminases 4xupper limit
ANAS 1:640
Total IgG 2400mg/dL
Negative AMA, ASMA, LKM
Hepatotropic virus infections profile negative
Lodato et al. [33] Acute cholestatic hepatitis Pfizer- BioNTech mRNA vaccine 15 days after 1 dose Total bilirubin 17.54 mg/dL, Direct bilirubin 12.94 mg/dL, GTP 52 U/L, GOT 51 U/L.
Normal IgG
Negative ANAS, ASMA, LKM1, AMA, ENAS
Hepatotropic virus infections profile negative
Capassoni et al. [43] Polymyositis AstraZeneca ChAdOx1 nCoV-19 vaccine 4 days after White cell count 13000, 76% neutrophils, CRP elevation
Procalcitonin negative.
Aldolase raise (10,3 U/L NV < 7.6)
ANAS 1:160, borderline positivity Anti-Pm/scl-75 antibodies
Electromyography: moderate severity subacute myositis without muscle damage and polyneuropathy.
Conticini et al. [44] Relapse of microscopic polyangiitis Pfizer- BioNTech mRNA vaccine Few days after 1 dose Arterial blood pO2 48 mm Hg)
CRP 3.7 mg/dL, creatinine 1.55 mg/dL
Negative autoimmunity blood tests
High‐resolution computed tomography: diffuse “ground‐glass” opacities with superimposed septal thickening and subpleural consolidations
Sauret et al. [13] Giant Cell Arteritis AstraZeneca ChAdOx1 nCoV-19 vaccine Few days after 1 dose GGT 112 U/L, ALP 40 U/L
Authors did not performed autoantibodies
Ishay et al. [10] Pfizer- BioNTech mRNA vaccine Case 1: 3 days after 1 dose Case 1: Negative ANAs, RF, and anti-CCP antibodies
Case 1: Symmetric polyarthritis Case 2: 10 days after 1 dose Case 2: No autoantibodies
Case 2: Exacerbation of Beçet disease Case 3: 1 day after 1 dose Case 3: No autoantibodies
Case 3: Pericarditis Case 4: 3 days after 1 dose Case 4: No autoantibodies
Case 4: Termporal arteritis like disease Case 5: Few hours after 1 dose Case 5: No autoantibodies
Case 5: Case 6: 14 days after 2 doses Case 6: No autoantibodies
Fever of unknown origin Case 7: 10 days after 1 dose Case 7: No autoantibodies
Case 6: Oligoarthritis Case 8: 2 weeks after 2 doses Case 8: White cells count 12,700/μL, CRP 1.4 mg/dL,
Case 7: Pericarditis Troponin 103 ng/L, CPK 2380 U/L, no autoantibodies
Case 8: Myocarditis

TSH: Thyroid-stimulating hormone; fT4: free thyroxine; TPO: thyroid peroxidase; Tg: Thyroglobulin; TRAB: thyrotropin receptor antibody; CRP: C-Reactive Protein, ESR: erythrocyte sedimentation rate; USG: ultrasonography; INR: international normalized ratio; LDH: lactate dehydrogenase; ANAs: antinuclear antibody; MPO: myeloperoxidase; p-ANCA: perinuclear anti-neutrophil cytoplasmic antibodies; c-ANCA: centrally antineutrophil cytoplasmic antibodies; IAT: indirect antiglobulin test; DAT: direct antiglobulin test; MCV: mean corpuscular volume; IgG: immunoglobulin G; C3: complement C3; RF: rheumatoid factor; CCP: cyclic citrullinated peptide; HLA: human leukocyte antigens; IL-6: interleukin-6; C4: complement C4; dsDNA: double-stranded deoxyribonucleic acid; ENAs: extractable nuclear antigen; ACE: angiotensin-converting enzyme; IgA: immunoglobulin A; IgM: immunoglobulin; MOG: myelin oligodendrocyte glycoprotein; CSF: cerebrospinal fluid; GM1: gangliosidosis-1; GQIb: Ganglioside GQIb; GM2: gangliosidosde-2; MAG: myelin associated glycoprotein; GAD: glutamic acid decarboxylase; GOT: glutamic-oxaloacetic transaminase; GPT: glutamic pyruvic transaminase. GGT: gamma-glutamyl transferase; ALP: alkaline phosphatase; ASMA: anti-smooth muscle antibody; SLA: soluble liver antigen; LKM1: liver kidney microsomal type 1; LC1: liver cytosolic antigen type 1; AMA: antimitochondrial antibodies; U1-snRNP: U1 small nuclear ribonucleoprotein particle; CENP: centromere protein B; Rib-P:ribosomal P protein; PCNA: Proliferating cell nuclear antigen; AMA-M2: Anti-mitochondrial M2 antibody, CPK: creatine phosphokinase.