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Thrombotic Thrombocytopenic Purpura Following Chadox1 Ncov-19 Vaccination: A Case Report Publisher



Shateri Amiri B1, 2, 3, 4, 5 ; Radkhah H1, 2, 3, 4, 5 ; Taslimi R1, 2, 3, 4, 5 ; Shahbazi Dastjerdi Z1, 2, 3, 4, 5 ; Khadembashiri MM1, 2, 3, 4, 5 ; Gholizadeh Mesgarha M1, 2, 3, 4, 5 ; Rahimipour Anaraki S1, 2, 3, 4, 5
Authors
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Authors Affiliations
  1. 1. Department of Internal Medicine, School of Medicine, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Iran
  2. 2. Department of Internal Medicine, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Internal Medicine, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Faculty of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran

Source: IDCases Published:2023


Abstract

Vaccine-associated thrombotic thrombocytopenic purpura (TTP) is a rare type of acquired TTP recently reported after COVID-19 vaccination. Merely four cases are ascribed to the ChAdOx1 nCoV-19 vaccine in the medical literature till the preparation of this study. In this case report, we describe a 43-year-old man who developed symptoms of TTP four days after receiving the second dose of the ChAdOx1 nCoV-19 vaccine. Peripheral blood smear demonstrated multiple schistocytes. Given a high plasmic score, he received plasma exchange, corticosteroids, and rituximab, and later, low ADAMTS 13 activity and high-titer ADAMTS inhibition antibody confirmed the diagnosis of COVID-19 vaccine-associated TTP. COVID-19 vaccine-associated TTP is an infrequent consequence of SARS-CoV-2 vaccination but with a substantial mortality rate which must be considered as one of the crucial differential diagnoses of post-COVID-19 vaccine thrombocytopenia besides vaccine-induced immune thrombotic thrombocytopenia and Immune thrombocytopenic purpura. © 2023 The Authors