Acquired Thrombotic Thrombocytopenic Purpura After BNT162b2 COVID-19 Vaccine : Case Report and Literature Review

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Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy that is deadly if not treated promptly. The treatment of choice in patients presenting with TTP is plasma exchanges. However, immunosuppressive therapy and caplacizumab have significantly improved outcomes in TTP. This microangiopathy is classically divided into 2 entities: hereditary and acquired TTP (aTTP), caused by an autoantibody against ADAMTS 13. We present a case study of a patient wth TTP occurring after a second dose of the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine along with a review of the literature. A 55-year-old patient presented with gastrointestinal symptoms, anemia, and severe thrombocytopenia. The blood film revealed the presence of schistocytes. A diagnosis of aTTP was established because the patient had severe ADAMTS 13 deficiency and autoantibodies against ADAMTS 13 were positive. This episode occurred 10 days after the patient received the COVID-19 vaccine. The patient received plasma exchanges, prednisone, rituximab, and caplacizumab and achieved complete remission. Ten patients with aTTP induced by the COVID-19 vaccine have been reported in the literature. Most of these situations occurred after the second dose of COVID-19 vaccine, and 7 patients were noted to have received the BNT162b2 vaccine. Caplacizumab was used in 6 patients, and complete remission was achieved in 8 patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:53

Enthalten in:

Laboratory medicine - 53(2022), 6 vom: 03. Nov., Seite e145-e148

Sprache:

Englisch

Beteiligte Personen:

Hammami, Emna [VerfasserIn]
Lamarque, Mathilde [VerfasserIn]
Aujoulat, Olivier [VerfasserIn]
Debliquis, Agathe [VerfasserIn]
Drénou, Bernard [VerfasserIn]
Harzallah, Inès [VerfasserIn]

Links:

Volltext

Themen:

ADAMTS13 Protein
Autoantibodies
BNT162 Vaccine
COVID-19
COVID-19 Vaccines
Case Reports
EC 3.4.24.87
Journal Article
Microangiopathy
Review
Thrombocytopenia
Thrombosis
Thrombotic thrombocytopenic purpura
Vaccine

Anmerkungen:

Date Completed 04.11.2022

Date Revised 24.03.2023

published: Print

Citation Status MEDLINE

doi:

10.1093/labmed/lmac016

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM340111577