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[Severe thrombocytopenia after COVID-19 mRNA vaccination]
Masao Hagihara1, Tomoyuki Uchida1, Morihiro Inoue1
1Department of Hematology, Eiju General Hospital.
Abstract:
The Japanese Society of Hematology recently published on acute exacerbation of immune-mediated thrombocytopenia (ITP) after mRNA-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. In addition, there is a growing concern for the development of the newly diagnosed ITP after SARS-CoV-2 vaccination. Herein, we report two cases of severe thrombocytopenia associated with bleeding tendencies at 4 and 14 days after BNT162b2 mRNA vaccination. Platelet counts returned to normal following platelet transfusion or treatment with intravenous immunoglobulin and dexamethasone. To our knowledge at the time of the draft of this manuscript, nine cases of SARS-CoV-2 vaccine-induced ITP have been reported. Although most patients showed favorable clinical courses similar to that of our cases, critical thrombocytopenia can lead to unfavorable outcomes. A national survey may be required to examine the causal relationship between SARS-CoV-2 vaccination and the emergence of the newly diagnosed ITP and clinical outcomes of vaccine-induced thrombocytopenia.
Insights
Two cases of severe thrombocytopenia, a bleeding disorder, occurred after COVID-19 mRNA vaccination. Treatment led to recovery, but further study is needed to understand vaccine-induced immune thrombocytopenia risks.
Area of Science:
- Immunology
- Vaccinology
- Hematology
Background:
- Immune-mediated thrombocytopenia (ITP) is a concern following mRNA-based SARS-CoV-2 vaccination.
- Reports indicate a potential link between SARS-CoV-2 vaccination and newly diagnosed ITP.
Purpose of the Study:
- To report two cases of severe thrombocytopenia post-BNT162b2 mRNA vaccination.
- To discuss the clinical course and management of vaccine-associated ITP.
- To highlight the need for further investigation into SARS-CoV-2 vaccine-induced ITP.
Main Methods:
- Case report of two patients experiencing severe thrombocytopenia after BNT162b2 mRNA vaccination.
- Review of existing literature on SARS-CoV-2 vaccine-induced ITP.
- Discussion of treatment modalities including platelet transfusion, IVIG, and dexamethasone.
Main Results:
- Two patients developed severe thrombocytopenia with bleeding tendencies 4 and 14 days post-vaccination.
- Platelet counts normalized with treatment.
- Nine cases of SARS-CoV-2 vaccine-induced ITP were reported at the time of writing, mostly with favorable outcomes.
Conclusions:
- BNT162b2 mRNA vaccination may be associated with immune-mediated thrombocytopenia.
- While most cases have favorable outcomes, critical thrombocytopenia poses risks.
- A national survey is recommended to investigate the causal relationship and clinical outcomes.
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