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[Immune thrombocytopenia after BNT162b2 mRNA COVID-19 vaccination].
Rinsho Ketsueki. 2021; 62(12):1688-1693.RK

Abstract

A 95-year-old male developed general subcutaneous petechiae, tongue hematoma, and melena two days after receiving the second BNT162b2 mRNA COVID-19 vaccine. Two days later, his platelet count decreased to below 1,000/µl. Laboratory testing was positive for a slight increase in D-dimer, Helicobacter pylori (H. pylori) immunoglobulin G (IgG) antibody, lupus anticoagulant, and anticardiolipin IgG antibody levels. There were no severe infections or symptomatic thrombosis. Platelet transfusions were transiently effective. He was diagnosed with newly developed immune thrombocytopenia (ITP). We administered prednisolone (PSL) at 0.5 mg/kg/day and intravenous immunoglobulin (IVIG) at 0.4 g/kg/day. From the following day, his platelet count rapidly increased, with an improvement in bleeding tendency. H. pylori was eradicated after platelet count recovery. Thrombocytopenia did not relapse although PSL was tapered three months later. Causes of thrombocytopenia after SARS-CoV-2 vaccination include ITP, vaccine-induced immune thrombotic thrombocytopenia, and thrombotic thrombocytopenic purpura. Differential diagnosis is important to determine the proper therapy. Case reports of newly diagnosed ITP after SARS-CoV-2 vaccination have been increasing recently. In these cases, including ours, the responses to steroids and IVIG were good. Further follow-up studies are needed to manage thrombocytopenia following SARS-CoV-2 vaccination.

Authors+Show Affiliations

Department of Internal Medicine, Minaminagano Medical Center Shinonoi General Hospital. Department of Hematology, Nagano Red Cross Hospital.Department of Internal Medicine, Minaminagano Medical Center Shinonoi General Hospital.Department of Hematology, Nagano Red Cross Hospital.Department of Hematology, Nagano Red Cross Hospital.

Pub Type(s)

Case Reports
Journal Article

Language

jpn

PubMed ID

35022338

Citation

Sato, Keijiro, et al. "[Immune Thrombocytopenia After BNT162b2 mRNA COVID-19 Vaccination]." [Rinsho Ketsueki] the Japanese Journal of Clinical Hematology, vol. 62, no. 12, 2021, pp. 1688-1693.
Sato K, Anayama M, Sumi M, et al. [Immune thrombocytopenia after BNT162b2 mRNA COVID-19 vaccination]. Rinsho Ketsueki. 2021;62(12):1688-1693.
Sato, K., Anayama, M., Sumi, M., & Kobayashi, H. (2021). [Immune thrombocytopenia after BNT162b2 mRNA COVID-19 vaccination]. [Rinsho Ketsueki] the Japanese Journal of Clinical Hematology, 62(12), 1688-1693. https://doi.org/10.11406/rinketsu.62.1688
Sato K, et al. [Immune Thrombocytopenia After BNT162b2 mRNA COVID-19 Vaccination]. Rinsho Ketsueki. 2021;62(12):1688-1693. PubMed PMID: 35022338.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Immune thrombocytopenia after BNT162b2 mRNA COVID-19 vaccination]. AU - Sato,Keijiro, AU - Anayama,Mariko, AU - Sumi,Masahiko, AU - Kobayashi,Hikaru, PY - 2022/1/13/entrez PY - 2022/1/14/pubmed PY - 2022/1/15/medline KW - Adverse event KW - Immune thrombocytopenia KW - SARS-CoV-2 vaccine SP - 1688 EP - 1693 JF - [Rinsho ketsueki] The Japanese journal of clinical hematology JO - Rinsho Ketsueki VL - 62 IS - 12 N2 - A 95-year-old male developed general subcutaneous petechiae, tongue hematoma, and melena two days after receiving the second BNT162b2 mRNA COVID-19 vaccine. Two days later, his platelet count decreased to below 1,000/µl. Laboratory testing was positive for a slight increase in D-dimer, Helicobacter pylori (H. pylori) immunoglobulin G (IgG) antibody, lupus anticoagulant, and anticardiolipin IgG antibody levels. There were no severe infections or symptomatic thrombosis. Platelet transfusions were transiently effective. He was diagnosed with newly developed immune thrombocytopenia (ITP). We administered prednisolone (PSL) at 0.5 mg/kg/day and intravenous immunoglobulin (IVIG) at 0.4 g/kg/day. From the following day, his platelet count rapidly increased, with an improvement in bleeding tendency. H. pylori was eradicated after platelet count recovery. Thrombocytopenia did not relapse although PSL was tapered three months later. Causes of thrombocytopenia after SARS-CoV-2 vaccination include ITP, vaccine-induced immune thrombotic thrombocytopenia, and thrombotic thrombocytopenic purpura. Differential diagnosis is important to determine the proper therapy. Case reports of newly diagnosed ITP after SARS-CoV-2 vaccination have been increasing recently. In these cases, including ours, the responses to steroids and IVIG were good. Further follow-up studies are needed to manage thrombocytopenia following SARS-CoV-2 vaccination. SN - 0485-1439 UR - https://www.unboundmedicine.com/medline/citation/35022338/[Immune_thrombocytopenia_after_BNT162b2_mRNA_COVID_19_vaccination]_ DB - PRIME DP - Unbound Medicine ER -