Thrombotic thrombocytopenic purpura: a new menace after COVID bnt162b2 vaccine

Int J Hematol. 2021 Nov;114(5):626-629. doi: 10.1007/s12185-021-03190-y. Epub 2021 Jul 15.

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a known menace in hematology and is quite rare in practice with known triggers. Lately, in the COVID-19 pandemic, hematology has seen a new pathology amongst which TTP associated with COVID-19 messenger RNA (mRNA) vaccine is unique. We report a case of a 69-year-old male with multiple comorbidities who presented to the hospital with severe fatigue and shortness of breath. Labs were significant for thrombocytopenia, anemia, and hemolysis with schistocytes consistent with TTP with a second dose of BNT162b2 mRNA vaccine as a likely culprit been documented.

Keywords: COVID-19; TTP; Thrombocytopenia; Thrombosis; Vaccine.

Publication types

  • Case Reports
  • Review

MeSH terms

  • ADAMTS13 Protein / immunology
  • Aged
  • BNT162 Vaccine
  • COVID-19 Vaccines / adverse effects*
  • COVID-19 Vaccines / immunology
  • COVID-19* / prevention & control
  • Combined Modality Therapy
  • Dyspnea / etiology
  • Fatigue / etiology
  • HIV Infections / complications
  • Hepatitis B, Chronic / complications
  • Humans
  • Hypertension / complications
  • Immunization, Secondary / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Kidney Failure, Chronic / complications
  • Male
  • Pandemics*
  • Plasma Exchange
  • Purpura, Thrombotic Thrombocytopenic / blood
  • Purpura, Thrombotic Thrombocytopenic / etiology*
  • Purpura, Thrombotic Thrombocytopenic / therapy
  • SARS-CoV-2*
  • Venous Thrombosis / complications

Substances

  • COVID-19 Vaccines
  • Immunosuppressive Agents
  • ADAMTS13 Protein
  • ADAMTS13 protein, human
  • BNT162 Vaccine