Acquired Thrombotic Thrombocytopenic Purpura Following BNT162b2 mRNA Coronavirus Disease Vaccination in a Japanese Patient
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- Yoshida Kikuaki
- Department of Hematology/Oncology, Wakayama Medical University, Japan
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- Sakaki Ayaka
- Department of Hematology/Oncology, Wakayama Medical University, Japan
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- Matsuyama Yoriko
- Department of Hematology/Oncology, Wakayama Medical University, Japan Department of General Internal Medicine, Hashimoto Municipal Hospital, Japan
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- Mushino Toshiki
- Department of Hematology/Oncology, Wakayama Medical University, Japan
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- Matsumoto Masanori
- Department of Blood Transfusion Medicine, Nara Medical University, Japan
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- Sonoki Takashi
- Department of Hematology/Oncology, Wakayama Medical University, Japan
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- Tamura Shinobu
- Department of Hematology/Oncology, Wakayama Medical University, Japan
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Abstract
<p>A 57-year-old man without underlying diseases presented with fatigue, loss of appetite, and jaundice 1 week after receiving the first dose of the BNT162b2 mRNA coronavirus disease 2019 (COVID-19) vaccine and showed hemolytic anemia with fragmented erythrocytes and severe thrombocytopenia 2 weeks after receiving the vaccine. An a disintegrin-like and metalloproteinase with thrombospondin type 1 motifs 13 (ADAMTS13) activity level of <10% and ADAMTS13 inhibitor positivity confirmed the diagnosis of acquired thrombotic thrombocytopenic purpura (TTP). Combination therapy with plasma exchange, corticosteroid, and rituximab improved the clinical outcome. We herein report the first Japanese case of TTP possibly associated with vaccination. Physicians should be alert for this rare but life-threatening hematological complication following COVID-19 vaccination. </p>
Journal
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- Internal Medicine
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Internal Medicine 61 (3), 407-412, 2022-02-01
The Japanese Society of Internal Medicine