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A Case Report of Immune Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination

Gyungah Kim, Eun‐Ji Choi, Han‐Seung Park, Jung‐Hee Lee, Je‐Hwan Lee, Kyoo‐Hyung Lee

2021Journal of Korean Medical Science17 citationsDOIOpen Access PDF

Abstract

Immune thrombocytopenia (ITP) is an autoimmune condition characterized by platelet destruction through antibody-mediated mechanism. ITP is one of the manifestations of a coronavirus disease, as well as an adverse event occurring after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several cases of ITP have been described after vaccination with two mRNA-based vaccines-BTN162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)-against SARS-CoV-2. Herein, we report a case of ITP occurring after vaccination with ChAdOx1 adenovirus vector nCoV-19 (AstraZeneca) vaccine in Korea. A 66-year-old woman presented with multiple ecchymoses on both upper and lower extremities and gingival bleeding, appearing 3 days after receiving the first dose of ChAdOx1 nCoV-19. Her laboratory results showed isolated severe thrombocytopenia without evidence of combined coagulopathy. She was diagnosed with ITP and successfully treated with high-dose dexamethasone and intravenous immunoglobulin. Clinical suspicion to identify vaccine-related ITP is important to promptly initiate appropriate treatment.

Topics & Concepts

MedicineVaccinationAdverse effectCoagulopathyImmunologyAntibodyImmune thrombocytopeniaImmune systemConsumptive CoagulopathyPlateletInternal medicinePlatelet Disorders and TreatmentsHeparin-Induced Thrombocytopenia and ThrombosisBlood groups and transfusion