Severe Immune Thrombocytopenia after COVID-19 Vaccination: Two Case Reports and a Literature Review

Intern Med. 2022 May 15;61(10):1581-1585. doi: 10.2169/internalmedicine.9177-21. Epub 2022 Mar 19.

Abstract

We herein report two cases of coronavirus disease 2019 (COVID-19) vaccine-induced immune thrombocytopenia (ITP). A 69-year-old Japanese man developed severe thrombocytopenia after COVID-19 vaccination. He had oral bleeding and hemoptysis but no thrombotic symptoms. He improved rapidly with oral prednisolone therapy. A 34-year-old Japanese woman had generalized purpura after COVID-19 vaccination. Her platelet count improved rapidly after treatment with prednisolone and eltrombopag. The occurrence of two cases of ITP after COVID-19 vaccination at a single institution suggests that there could be more such undiagnosed cases, especially cases of mild secondary ITP.

Keywords: COVID-19; immune thrombocytopenia; vaccination.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • COVID-19 Vaccines / adverse effects
  • COVID-19*
  • Female
  • Humans
  • Male
  • Prednisolone / therapeutic use
  • Purpura, Thrombocytopenic, Idiopathic* / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic* / drug therapy
  • Purpura, Thrombocytopenic, Idiopathic* / etiology
  • Thrombocytopenia* / chemically induced
  • Vaccination

Substances

  • COVID-19 Vaccines
  • Prednisolone