Evidence map›Paper›PMID 36107725›Full record

ArticleBMJ case reports2022

Severe refractory warm autoimmune haemolytic anaemia after the SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA) managed with emergency splenectomy and complement inhibition with eculizumab.

Emma Marguerite Jackson, Simon Harper, Gwilym J Webb, Will Thomas

Open access · greenAbstract readCase Reports
In one paragraph

Article in BMJ case reports, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Emma Marguerite JacksonClinical School, University of Cambridge, Cambridge, UK.
Simon HarperHepatopancreaticobiliary Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Gwilym J WebbDepartment of hepatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Will ThomasDepartment of haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK w.thomas1@nhs.net.
Cambridge University Hospitals NHS Foundation Trust · GBUniversity of Cambridge · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

A male in his teens with a history of liver transplant for biliary atresia (aged 2 years) and autoimmune haemolytic anaemia (AIHA, aged 6 years) presented with jaundice, dark urine, fatigue and chest discomfort that began 48 hours after the first dose of SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA). Investigations revealed a warm AIHA picture. Over 4 weeks the patient developed life-threatening anaemia culminating in haemoglobin of 35 g/L (after transfusion), lactate dehydrogenase of 1293 units/L and bilirubin of 228 µmol/L, refractory to standard treatment with corticosteroids and rituximab. An emergency splenectomy was performed that slowed haemolysis but did not completely ameliorate it. Eculizumab, a terminal complement pathway inhibitor, was initiated to arrest intravascular haemolysis and showed a favourable response. AIHA is rare but described after the SARS-CoV-2 Pfizer-BioNTech vaccine. This case highlights the rare complication of AIHA, the use of emergency splenectomy for disease control, and the use of eculizumab.

Indexed as

Anemia, Hemolytic, AutoimmuneBNT162 VaccineCOVID-19AdolescentAntibodies, Monoclonal, HumanizedBilirubinComplement Inactivating AgentsCOVID-19 VaccinesHemoglobinsHemolysisHumansImmunologic FactorsLactate DehydrogenasesMaleRituximabRNA, MessengerAntibodies, Monoclonal, HumanizedBilirubinBNT162 VaccineComplement Inactivating AgentsCOVID-19 VaccineseculizumabHemoglobinsImmunologic FactorsLactate DehydrogenasesRituximabRNA, MessengerHaematology (incl blood transfusion)Transplantation

Identifiers

PMID36107725
PMCPMC9438040
OpenAlexW4293755057

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.