Immune Thrombocytopenic Purpura after vaccination with COVID-19 Vaccine (ChAdOx1 nCov-19)

Paulsen, F.; Schaefers, Christoph; Frenzel, Christian; Wenzel, Ulrich; Hengel, Felicitas E.; Bokemeyer, Carsten; Seidel, Christoph

doi:10.1182/blood.2021012790

Cited by 23 publications

(20 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 3 , 4 Oxford AstraZeneca and Janssen (Ad.26.COV2.S) COVID‐19 (Johnson & Johnson) vaccines have been linked to vaccine‐induced immune thrombotic thrombocytopenia, 5 , 6 a postvaccination immune hematologic disorder distinct from TTP. Furthermore, there have been multiple case reports of ITP observed after administration of both Pfizer‐BioNTech mRNA and Moderna mRNA COVID‐19 vaccines, 7 , 8 , 9 some of which have been severe. The rapid onset of TTP in our cohort likely reflects the robust immunologic response induced by COVID‐19 vaccination or infection.…”

Section: Discussionmentioning

confidence: 99%

COVID‐19 vaccine (mRNA BNT162b2) and COVID‐19 infection‐induced thrombotic thrombocytopenic purpura in adolescents

Vorster

Kirk

Muscal

et al. 2022

Pediatric Blood & Cancer

View full text Add to dashboard Cite

The mRNA COVID-19 vaccine and COVID-19 infection caused by the SARS-CoV-2 virus may be immunologic triggers for the development of thrombotic thrombocytopenic purpura (TTP). There is not yet literature that discusses TTP induced by COVID-19 vaccination or infection in pediatric or adolescent patients. We describe three adolescents presenting with TTP (both de novo and relapsed disease) following administration of the Pfizer COVID-19 vaccine or after COVID-19 infection. Our observations demonstrate that the Pfizer-BioNTech mRNA vaccine and COVID-19 infection can act as triggers for the development/relapse of both congenital and acquired TTP.

show abstract

Section: Discussionmentioning

confidence: 99%

COVID‐19 vaccine (mRNA BNT162b2) and COVID‐19 infection‐induced thrombotic thrombocytopenic purpura in adolescents

Vorster

Kirk

Muscal

et al. 2022

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…Complications such as hematuria, extensive petechial hemorrhage, subarachnoid hemorrhage [ 178 ], immune thrombocytopenia [ 179 , 180 , 181 , 182 , 183 ], Evans syndrome [ 184 ], acquired hemophilia [ 185 ], and factor XIII inhibitor [ 186 ] have been reported with the use of adenovirus vector and mRNA vaccines. In particular, when platelet transfusion is performed for hemorrhagic disease, examination to rule out VITT should always be performed, because with the presence of VITT in the background, the underlying condition may be aggravated after platelet transfusion.…”

Section: Sars-cov-2 Vaccination-associated Coagulopathymentioning

confidence: 99%

Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination

Yamada

Asakura

2022

IJMS

View full text Add to dashboard Cite

Coronavirus Disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is frequently complicated by thrombosis. In some cases of severe COVID-19, fibrinolysis may be markedly enhanced within a few days, resulting in fatal bleeding. In the treatment of COVID-19, attention should be paid to both coagulation activation and fibrinolytic activation. Various thromboses are known to occur after vaccination with SARS-CoV-2 vaccines. Vaccine-induced immune thrombotic thrombocytopenia (VITT) can occur after adenovirus-vectored vaccination, and is characterized by the detection of anti-platelet factor 4 antibodies by enzyme-linked immunosorbent assay and thrombosis in unusual locations such as cerebral venous sinuses and visceral veins. Treatment comprises high-dose immunoglobulin, argatroban, and fondaparinux. Some VITT cases show marked decreases in fibrinogen and platelets and marked increases in D-dimer, suggesting the presence of enhanced-fibrinolytic-type disseminated intravascular coagulation with a high risk of bleeding. In the treatment of VITT, evaluation of both coagulation activation and fibrinolytic activation is important, adjusting treatments accordingly to improve outcomes.

show abstract

“…Vaccine-induced ITP has been associated with both live and inactivated vaccines (such as rubella, pneumococcus, and influenza vaccines) and has been linked to increased function of B-cells [58]. Furthermore, different types of COV-ID-19 vaccines have been reported to trigger de novo ITP including the Pfizer and Moderna (mRNA-based vaccines) and ChAdOx1 nCov-19 (AZD122; AstraZeneca) and Ad26.COV2.…”

Section: Covid-19 Vaccine-induced Immune Thrombocytopenic Purpuramentioning

confidence: 99%

“…Furthermore, different types of COV-ID-19 vaccines have been reported to trigger de novo ITP including the Pfizer and Moderna (mRNA-based vaccines) and ChAdOx1 nCov-19 (AZD122; AstraZeneca) and Ad26.COV2. S (Janssen) (vector-based vaccines) [58,59]. These patients had been treated with the same treatment options for COVID-19-induced ITP (such as IVIGs, glucocorticoids, or TPO-RAs) [58,59] [62].…”

Section: Covid-19 Vaccine-induced Immune Thrombocytopenic Purpuramentioning

confidence: 99%

“…S (Janssen) (vector-based vaccines) [58,59]. These patients had been treated with the same treatment options for COVID-19-induced ITP (such as IVIGs, glucocorticoids, or TPO-RAs) [58,59] [62]. The term 'vaccine -induced immune thrombotic thrombocytopenia (VITT)' refers to the thrombotic complications that occur following the administration of the adenovirus vector-based COVID-19 vaccines.…”

Section: Covid-19 Vaccine-induced Immune Thrombocytopenic Purpuramentioning

confidence: 99%

See 1 more Smart Citation

COVID-19-induced immune thrombocytopenic purpura; Immunopathogenesis and clinical implications

et al. 2022

View full text Add to dashboard Cite

Following the outbreak of the COVID-19 pandemic, millions of people around the world have been affected with SARS-CoV-2 infection. In addition to the typical symptoms, thrombotic events, lymphopenia, and thrombocytopenia have been reported in COVID-19 patients. Immune thrombocytopenic purpura (ITP) is one of the thrombotic events that occur in some COV-ID-19 patients. Hyperinflammation, cytokine storms, and immune dysregulation in some patients are the cause to the main COVID-19 complications such as ALI (acute lung injury), acute respiratory distress syndrome (ARDS), and multiple organ failure. Disruption in the differentiation of T-cells, enhanced differentiation of Th17 and Th1, cell death (pyroptosis), SUMMARYhyper-inflammation and dysfunction of inflammatory neutrophils and macrophages, and hyperactivity of NLRP3-inflammasome are among the important factors that may be the cause to COVID-19-induced ITP. This study aimed to give an overview of the findings on the immunopathogenesis of ITP and COVID-19-induced ITP. Further studies are required to better understand the exact immunopathogenesis and effective treatments for ITP, especially in inflammatory disorders.

show abstract

Immune Thrombocytopenic Purpura after vaccination with COVID-19 Vaccine (ChAdOx1 nCov-19)

Cited by 23 publications

References 19 publications

COVID‐19 vaccine (mRNA BNT162b2) and COVID‐19 infection‐induced thrombotic thrombocytopenic purpura in adolescents

COVID‐19 vaccine (mRNA BNT162b2) and COVID‐19 infection‐induced thrombotic thrombocytopenic purpura in adolescents

Coagulopathy and Fibrinolytic Pathophysiology in COVID-19 and SARS-CoV-2 Vaccination

COVID-19-induced immune thrombocytopenic purpura; Immunopathogenesis and clinical implications

Contact Info

Product

Resources

About