Mild encephalitis/encephalopathy with a reversible splenial lesion syndrome (MERS) is a rare clinico-radiological entity. Its occurrence after Rituximab (RTX) has never been described. We report the first case of MERS following RTX in a patient treated for IgG4 related disease (IgG4-RD). It was about a 33-year-old patient diagnosed since 2017, with an IgG4-RD. This diagnosis was made in front of a prolonged fever, sicca syndrome, hepatic damage and renal pseudotumor associated to a high level of IGg4 at 2.8 g/l with suggestive renal histology. The patient was treated with corticosteroid therapy with persistence of renal impairment and nephrotic syndrome that’s why RTX has been indicated. The patient received his first dose of RTX and presented few hours after, neurological and respiratory impairments. An infectious investigation comprising a SARS CoV-2 PCR and viral PCRs (VZV, Herpes and CMV) on cerebrospinal fluid (CSF) were negative. The HBV, HCV, HIV, Parvo B19, CMV, EBV, Herpes, Mycoplasma and syphilis serologies as well as Legionella antigenuria were also negative. The patient had received methylprednisone boli, intravenous immunoglobulin’s associated with sodium valproate with good evolution. The diagnosis of MERS induced by RTX is likely. However the viral aetiology is not excluded.

Drug-induced photosensitivity is a common problem that may be encountered with a variety of medications. Non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ketoprofen are notable examples. Herein we describe an uncommon manifestation of photosensitivity related to ketoprofen.

Statins are a widely used class of drug, usually safe and well-tolerated. Their cutaneous side effects are exceedingly rare. We describe a case of photoexposed purpuric eruption mediated by rosuvastatin.

The Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak from December 2019 causing millions of deaths all over the world and the lack of specific treatment for severe forms of coronavirus disease 2019 (COVID-19) has led to vaccines development in record time with emergency use authorization in several countries increasing the risk of vaccine safety issues. Recently, several cases of Thrombotic Thrombocytopenic Purpura (TTP) have been reported following COVID-19 vaccination. TTP represents a life-threatening consumptive coagulopathy requiring urgent diagnosis and prompt treatment. It is a rare disease characterized by thrombocytopenia, microangiopathic hemolytic anemia and ischemic end-organ lesions. It can be either congenital or acquired. Various events such viral infections, medication, pregnancy, malignancies, and vaccinations may cause TTP. Clinicians should consider this diagnosis when evaluating thrombocytopenia in the post-vaccine period. Here, we report two cases of acquired TTP following Sinopharm COVID-19 vaccine (BBIBP-CorV) and Sinovac COVID-19 vaccine (CoronaVac). Diagnosis was based on clinical presentation and confirmed with severe reduction in the activity of von Willebrand factor-cleaving protease ADAMTS-13 and the presence of inhibitory autoantibodies. The two patients were successfully treated with corticosteroids, plasma exchange therapy and rituximab in the acute phase. In the literature, the reported cases of TTP induced by COVID-19 vaccination occurred after Adenoviral Vector DNA- and SARS-CoV-2 mRNA-Based COVID-19 Vaccines. To the best of our knowledge, this is the first report of acquired TTP after inactivated virus COVID-19 vaccines. A short literature review regarding acquired TTP patients following COVID-19 vaccines is also included.