tetano
Editor, Senior Moderator
Res Pract Thromb Haemost
. 2022 Feb 7;6(1):e12658.
doi: 10.1002/rth2.12658. eCollection 2022 Jan.
Clinical relapse of immune-mediated thrombotic thrombocytopenic purpura following COVID-19 vaccination
William Deucher[SUP] 1 [/SUP], Senthil Sukumar[SUP] 2 [/SUP], Spero R Cataland[SUP] 2 [/SUP]
Affiliations
Abstract
De novo and relapsed immune-mediated thrombotic thrombocytopenic purpura (iTTP) have been documented to have occurred following severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccination. Here, we present a case of a 28-year-old woman who received the tozinameran (BNT162b2, Pfizer-BioNtech) vaccine for COVID-19 and experienced an iTTP relapse during longitudinal follow-up. She received the vaccine 30 months after her initial diagnosis, while she was in clinical remission. She was not in complete ADAMTS-13 remission, as she had undetectable ADAMTS-13 activity during follow-up except for one isolated measurement of 48%. Shortly after vaccination, she developed complaints of bruising, petechiae, ataxia, and an episode of slurred speech. Laboratory testing demonstrated thrombocytopenia, schistocytes, and eventually undetectable ADAMTS-13 activity. She was successfully treated with caplacizumab, rituximab, and corticosteroids without plasma exchange. She achieved complete clinical and ADAMTS-13 remission after treatment. We recommend caution in the administration of COVID-19 vaccines for survivors of iTTP in remission with severely deficient ADAMTS-13 activity.
Keywords: ADAMTS‐13; COVID‐19; Pfizer‐BioNTech SARS‐CoV‐2 vaccine; caplacizumab; thrombotic thrombocytopenia purpura.
. 2022 Feb 7;6(1):e12658.
doi: 10.1002/rth2.12658. eCollection 2022 Jan.
Clinical relapse of immune-mediated thrombotic thrombocytopenic purpura following COVID-19 vaccination
William Deucher[SUP] 1 [/SUP], Senthil Sukumar[SUP] 2 [/SUP], Spero R Cataland[SUP] 2 [/SUP]
Affiliations
- PMID: 35155977
- PMCID: PMC8822264
- DOI: 10.1002/rth2.12658
Abstract
De novo and relapsed immune-mediated thrombotic thrombocytopenic purpura (iTTP) have been documented to have occurred following severe acute respiratory syndrome coronavirus 2 (COVID-19) vaccination. Here, we present a case of a 28-year-old woman who received the tozinameran (BNT162b2, Pfizer-BioNtech) vaccine for COVID-19 and experienced an iTTP relapse during longitudinal follow-up. She received the vaccine 30 months after her initial diagnosis, while she was in clinical remission. She was not in complete ADAMTS-13 remission, as she had undetectable ADAMTS-13 activity during follow-up except for one isolated measurement of 48%. Shortly after vaccination, she developed complaints of bruising, petechiae, ataxia, and an episode of slurred speech. Laboratory testing demonstrated thrombocytopenia, schistocytes, and eventually undetectable ADAMTS-13 activity. She was successfully treated with caplacizumab, rituximab, and corticosteroids without plasma exchange. She achieved complete clinical and ADAMTS-13 remission after treatment. We recommend caution in the administration of COVID-19 vaccines for survivors of iTTP in remission with severely deficient ADAMTS-13 activity.
Keywords: ADAMTS‐13; COVID‐19; Pfizer‐BioNTech SARS‐CoV‐2 vaccine; caplacizumab; thrombotic thrombocytopenia purpura.