tetano
Editor, Senior Moderator
Intern Med
. 2021 Nov 20.
doi: 10.2169/internalmedicine.8568-21. Online ahead of print.
Acquired Thrombotic Thrombocytopenic Purpura Following BNT162b2 mRNA Coronavirus Disease Vaccination in a Japanese Patient
Kikuaki Yoshida[SUP] 1 [/SUP], Ayaka Sakaki[SUP] 1 [/SUP], Yoriko Matsuyama[SUP] 1 2 [/SUP], Toshiki Mushino[SUP] 1 [/SUP], Masanori Matsumoto[SUP] 3 [/SUP], Takashi Sonoki[SUP] 1 [/SUP], Shinobu Tamura[SUP] 1 [/SUP]
Affiliations
Abstract
A 57-year-old man without underlying diseases presented with fatigue, loss of appetite, and jaundice 1 week after receiving the first dose of the BNT162b2 mRNA coronavirus disease (COVID-19) vaccine and showed hemolytic anemia with fragmented erythrocytes and severe thrombocytopenia 2 weeks after receiving the vaccine. An ADAMTS13 activity level of <10% and ADAMTS13 inhibitor positivity confirmed the diagnosis of acquired thrombotic thrombocytopenic purpura (TTP). Combination therapy with plasma exchange, corticosteroid, and rituximab improved the clinical outcome. We herein report the first Japanese case of TTP possibly associated with vaccination. Physicians should be alert for this rare but life-threatening hematological complication following COVID-19 vaccination.
Keywords: BNT162b2 mRNA vaccine; Covid-19; acquired thrombotic thrombocytopenic purpura; plasma exchange.
. 2021 Nov 20.
doi: 10.2169/internalmedicine.8568-21. Online ahead of print.
Acquired Thrombotic Thrombocytopenic Purpura Following BNT162b2 mRNA Coronavirus Disease Vaccination in a Japanese Patient
Kikuaki Yoshida[SUP] 1 [/SUP], Ayaka Sakaki[SUP] 1 [/SUP], Yoriko Matsuyama[SUP] 1 2 [/SUP], Toshiki Mushino[SUP] 1 [/SUP], Masanori Matsumoto[SUP] 3 [/SUP], Takashi Sonoki[SUP] 1 [/SUP], Shinobu Tamura[SUP] 1 [/SUP]
Affiliations
- PMID: 34803105
- DOI: 10.2169/internalmedicine.8568-21
Abstract
A 57-year-old man without underlying diseases presented with fatigue, loss of appetite, and jaundice 1 week after receiving the first dose of the BNT162b2 mRNA coronavirus disease (COVID-19) vaccine and showed hemolytic anemia with fragmented erythrocytes and severe thrombocytopenia 2 weeks after receiving the vaccine. An ADAMTS13 activity level of <10% and ADAMTS13 inhibitor positivity confirmed the diagnosis of acquired thrombotic thrombocytopenic purpura (TTP). Combination therapy with plasma exchange, corticosteroid, and rituximab improved the clinical outcome. We herein report the first Japanese case of TTP possibly associated with vaccination. Physicians should be alert for this rare but life-threatening hematological complication following COVID-19 vaccination.
Keywords: BNT162b2 mRNA vaccine; Covid-19; acquired thrombotic thrombocytopenic purpura; plasma exchange.