Thrombotic thrombocytopenic purpura after ChAdOx1 nCoV-19 vaccine


Posted: 2021-10-09 19:00:00
BMJ Case Rep . 2021 Oct 8;14(10):e246049. doi: 10.1136/bcr-2021-246049. Affiliations Expand Affiliations 1 College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands, UK leehp1998@gmail.com. 2 Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, West Midlands, UK. 3 Haematology, Hospital Ampang, Ampang, Malaysia. 4 Haematology, Gleneagles Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia. Item in Clipboard Hui Ping Lee et al. BMJ Case Rep. 2021. Show details Display options Display options Format BMJ Case Rep . 2021 Oct 8;14(10):e246049. doi: 10.1136/bcr-2021-246049. Affiliations 1 College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands, UK leehp1998@gmail.com. 2 Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, West Midlands, UK. 3 Haematology, Hospital Ampang, Ampang, Malaysia. 4 Haematology, Gleneagles Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia. Item in Clipboard CiteDisplay options Display options Format Abstract A 50-year-old Indian woman presented with acute dysphasia, left upper limb numbness and thrombocytopenia 12 days after receiving the ChAdOx1 nCoV-19 vaccine (AstraZeneca/Vaxzevria). MRI of the brain was unremarkable. Microangiopathic haemolytic anaemia with thrombocytopenia was noted on her peripheral blood film. A diagnosis of thrombotic thrombocytopenic purpura (TTP) was confirmed through the findings of absent ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) activity and markedly raised titre of ADAMTS13 autoantibodies. Prompt treatment with plasma exchange, adjunctive steroids and rituximab was commenced. A remission of TTP was achieved and she was discharged 3 weeks after admission. While other immune-mediated conditions have been documented after receipt of the vaccine, this report highlights the first case of immune-mediated TTP diagnosed after administration of the ChAdOx1 nCoV-19 vaccine. Keywords: COVID-19; haematology (drugs and medicines); immunological products and vaccines; thrombotic thrombocytopenic purpura. © BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ. Conflict of interest statement Competing interests: None declared. [x] Cite Copy Format: Send To [x]

参考サイト PubMed: covid-19



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