Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Severe Limb Purpura Following the Administration of COVID-19 Vaccination on a Diabetic Foot Requiring Amputation: A Case Report

COVID-19 백신 투여 이후 발생한 심한 사지 자반증이 절단을 요하는 당뇨발에 미치는 영향: 증례 보고

  • Kim, Byung Ho (Department of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Suh, Jin Soo (Department of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Chang, Sun Hee (Department of Pathology, Ilsan Paik Hospital, Inje University College of Medicine) ;
  • Choi, Jun Young (Department of Orthopaedic Surgery, Ilsan Paik Hospital, Inje University College of Medicine)
  • 김병호 (인제대학교 의과대학 일산백병원 정형외과) ;
  • 서진수 (인제대학교 의과대학 일산백병원 정형외과) ;
  • 장선희 (인제대학교 의과대학 일산백병원 병리과) ;
  • 최준영 (인제대학교 의과대학 일산백병원 정형외과)
  • Received : 2021.11.16
  • Accepted : 2022.01.06
  • Published : 2022.03.15
Download PDF
⟨ Previous Next ⟩

Abstract

The current SARS-CoV-2 coronavirus disease 2019 (COVID-19) pandemic has been a particular challenge for diabetes patients. Since these patients are at a higher risk of COVID-19, they have been prioritized for vaccination. In this report, we describe the case of a patient scheduled for diabetic foot amputation who received the first dose of ChAdOx1 nCov-19 vaccine and subsequently developed severe purpura in his genitalia and both of his hands and feet, accompanied by acute renal failure. The operation had to be postponed as severe limb purpura appeared just before the operation. With adequate management for acute renal failure and topical steroid application for the severe purpura lesions, a successful outcome could be obtained after the delayed first ray amputation. We recommend that COVID-19 vaccination should be carefully administered in patients with a diabetic foot requiring amputation.

Keywords

References

  1. Pormohammad A, Zarei M, Ghorbani S, Mohammadi M, Razizadeh MH, Turner DL, et al. Efficacy and safety of COVID-19 vaccines: a systematic review and meta-analysis of randomized clinical trials. Vaccines (Basel). 2021;9:467. doi: 10.3390/vaccines9050467.
  2. Forni G, Mantovani A. COVID-19 vaccines: where we stand and challenges ahead. Cell Death Differ. 2021;28:626-39. doi: 10.1038/s41418-020-00720-9.
  3. World Health Organization.COVID-19 vaccine tracker and landscape. Geneva: World Health Organization; 2021.
  4. Cines DB, Bussel JB. SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia. N Engl J Med. 2021;384:2254-6. doi: 10.1056/NEJMe2106315.
  5. Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N Engl J Med. 2021;384:2092-101. doi: 10.1056/NEJMoa2104840.
  6. Schultz NH, Sorvoll IH, Michelsen AE, Munthe LA, Lund-Johansen F, Ahlen MT, et al. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384:2124-30. https://doi.org/10.1056/NEJMoa2104882
  7. Pottegard A, Lund LC, Karlstad O, Dahl J, Andersen M, Hallas J, et al. Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: population based cohort study. BMJ. 2021;373:n1114. doi: 10.1136/bmj.n1114.
  8. Scully M, Singh D, Lown R, Poles A, Solomon T, Levi M, et al. Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384:2202-11. doi: 10.1056/NEJMoa2105385.
  9. Simpson CR, Shi T, Vasileiou E, Katikireddi SV, Kerr S, Moore E, et al. First-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland. Nat Med. 2021;27:1290-7. doi: 10.1038/s41591-021-01408-4.
  10. Kharkar V, Vishwanath T, Mahajan S, Joshi R, Gole P. Asymmetrical cutaneous vasculitis following COVID-19 vaccination with unusual eosinophil preponderance. Clin Exp Dermatol. 2021;46:1596-7. doi: 10.1111/ced.14797.
  11. Cohen SR, Prussick L, Kahn JS, Gao DX, Radfar A, Rosmarin D. Leukocytoclastic vasculitis flare following the COVID-19 vaccine. Int J Dermatol. 2021;60:1032-3. doi: 10.1111/ijd.15623.
  12. Bostan E, Gulseren D, Gokoz O. New-onset leukocytoclastic vasculitis after COVID-19 vaccine. Int J Dermatol. 2021;60:1305-6. doi: 10.1111/ijd.15777.
  13. Watanabe T. Vasculitis following influenza vaccination: a review of the literature. Curr Rheumatol Rev. 2017;13:188-96. doi: 10.2174/1573397113666170517155443.
  14. Bonetto C, Trotta F, Felicetti P, Alarcon GS, Santuccio C, Bachtiar NS, et al. Vasculitis as an adverse event following immunization - systematic literature review. Vaccine. 2016;34:6641-51. doi: 10.1016/j.vaccine.2015.09.026.
  15. Guimaraes LE, Baker B, Perricone C, Shoenfeld Y. Vaccines, adjuvants and autoimmunity. Pharmacol Res. 2015;100:190-209. doi: 10.1016/j.phrs.2015.08.003.