Thrombotic thrombocytopenic purpura (TTP) is a type of thrombotic microangiopathy that is characterized by microangiopathic haemolytic anaemia, consumption thrombocytopenia and organ injury. It is caused by a severe deficiency of ADAMTS13, which can be either congenital or acquired. There is a plethora of things that can cause the acquired form, including medications and infections. Vaccines have also been shown to cause TTP. In the midst of the COVID-19 pandemic, with multiple new vaccines being developed and distributed to the masses, the medical community needs to be aware of adverse events associated with these new vaccines. We present a case of TTP following administration of the Moderna booster vaccine.
INNO-LiPA Extra-II kit (Fujirebio), based on PCR-reverse hybridization. Results Among 110 women with CIN2/3 (n=19) and invasive cancer (n=91), early antibodies to any HPV early antigen were detected in 58(53%). The difference between CIN2/3 (47.4%) and cancer (53.8%) was not significant (p=0.62). All 58 were positive for antibodies to HPV16 CE2/NE6/E7. HPV18/31/45 E7 antibodies were detected additionally in 1,1 and 2 cases, respectively. Among 40 controls (normal cytology and negative HPV DNA on Hybrid Capture), any early HPV antibodies were detected in 8(20.0%) cases with HPV16 CE2/ NE6/E7 in 3(7.5%), HPV18 E7 in 2(5%), HPV31 E7 in 5 (12.5%), and HPV45 E7 in 3(7.5%). On HPV genotyping, 88 (80.0%) cases had any high-risk (hr)HPV type, commonest being HPV16(69%), HPV18(5%), HPV31/33(3% each), HPV35/45/59(2% each). Single hrHPV infections were detected in 77 patients, 7 had single hrHPV infections other than HPV16. Multiple hrHPV infections were detected in 11 (10%) patients. Conclusions The serological test detects a high proportion of cases detected by INNO-LiPA. Further development of this simple, affordable technology holds promise to facilitate cervical screening and triage in community settings.
Immune thrombocytopenia (ITP) has been associated with immunizations with various proposed mechanisms, including overactivation of the immune system and production of antibodies against circulating platelets. ITP has also been associated with several viral infections, including HCV, HIV, and most recently, active SARS-CoV-2 infection. Here, we present a case of a 52-year-old male with no past medical history who sought evaluation with his primary care physician for upper and lower extremity ecchymosis of one week duration. Outpatient laboratory studies were notable for severe isolated thrombocytopenia with platelet count of 8 × 10^9/L. Interestingly, he received the Johnson and Johnson COVID-19 vaccine 16 days prior to his presentation. Clinical work up and laboratory investigations led to the diagnosis of ITP.
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