Immune thrombocytopenia during the COVID‐19 pandemic

Lee, Eun‐Ju; Liu, Xinguang; Hou, Ming; Bussel, James B.

doi:10.1111/bjh.17457

Cited by 9 publications

(10 citation statements)

References 14 publications

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“…We report the largest single‐center cohort in the United Kingdom of vaccine‐induced ITP relapse or new ITP diagnosis following SARS‐CoV‐2 vaccination. Of note, this new clinical entity within ITP patients following SARS‐CoV‐2 vaccination differs from the expected hematological challenges that faced ITP patients with COVID‐19 disease 14 …”

Section: Introductionmentioning

confidence: 88%

“…Of note, this new clinical entity within ITP patients following SARS‐CoV‐2 vaccination differs from the expected hematological challenges that faced ITP patients with COVID‐19 disease. 14 …”

Section: Introductionmentioning

confidence: 99%

“…10,11,14). Of the four non-responsive patients, two patients had a platelet count <100 × 10 9 /L prior to vaccination (88 × 10 9 /L and 96 × 10 9 /L) and two patients had a platelet count >100 × 10 9 /L prior to treatment (190 × 10 9 /L and 312 × 10 9 /L).Three out of the four patients in the non-responding group experienced bleeding symptoms at presentation.…”

mentioning

confidence: 99%

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Real‐world, single‐center experience of SARS‐CoV‐2 vaccination in immune thrombocytopenia

Woolley

Tailor

Shah

et al. 2022

Journal of Thrombosis and Haemostasis

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Background: Immune thrombocytopenic purpura (ITP) relapse following vaccination remains poorly reported in the adult population.Objectives: This report details real world data from the largest single-center cohort of ITP relapse following severe acute respiratory syndrome (SARS-CoV-2) vaccination. Methods:The vaccination status of 294 patients under active follow-up was reviewed. A total of 17 patients were identified resulting in an incidence of ITP relapse following SARS-CoV-2 vaccination in this cohort of 6.6% and an incidence of newly diagnosed ITP following SARS-CoV-2 vaccination of 1.4%. Results: Patients were noted to develop marked deviation of platelet count from baseline following vaccination (P =< .0001). Fourteen patients had a prior diagnosis of ITP and median follow-up following diagnosis was 4 years (range 0-45 years). Days from vaccination to presentation ranged from 2-42 (median 14) and the follow-up period was 34 weeks. Fifteen patients (88%) presented with symptoms and all 17 patients developed symptoms during the follow-up period. Nine patients (53%) received a second dose of vaccine during the follow-up period with seven patients (78%) requiring therapeutic support to facilitate second vaccination. Decision to treat patients was multi-factorial and aimed at decreasing bleeding symptoms and obtaining a platelet count >30 × 10 9 /L. Sixteen patients (94%) required therapeutic intervention and at the end of the follow-up period, four patients (24%) remained unresponsive to treatment with a platelet count <30 × 10 9 /L. Conclusion: Vaccination of ITP patients continues to have important clinical benefit; however, recommendations for patients who relapse remain lacking. This report outlines the real-world patient outcomes in the era of widespread SARS-CoV-2 vaccination.

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Section: Introductionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Real‐world, single‐center experience of SARS‐CoV‐2 vaccination in immune thrombocytopenia

Woolley

Tailor

Shah

et al. 2022

Journal of Thrombosis and Haemostasis

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“… 15–17 In addition, post-COVID-19 vaccination flare-ups have been reported among patients with chronic ITP. 18–20 However, few cases of chronic ITP flare-ups post-COVID-19 infection have been reported, 4–7 and information about its clinical characteristics is limited.…”

Section: Discussionmentioning

confidence: 99%

“…Since the emergence of coronavirus disease 2019 (COVID-19) as a global pandemic, its pathological impacts on various types of immune-mediated hematologic diseases, such as ITP, have been reported; however, information about its clinical features, treatment strategy, and biomarkers for treatment response with chronic ITP that re-worsened in association with COVID-19 infection have been rather limited. 4–7 …”

Section: Introductionmentioning

confidence: 99%

Clinical Implication of the Effect of the Production of Neutralizing Antibodies Against SARS-Cov-2 for Chronic Immune Thrombocytopenia Flare-Up Associated with COVID-19 Infection: A Case Report and the Review of Literature

Maekura¹,

Muramatsu²,

Nagata³

et al. 2022

IDR

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Previous studies have demonstrated that the appropriate production of serum anti-severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) neutralizing antibody (nAb) plays a critical role in the recovery from coronavirus disease 2019 (COVID-19); however, the role of nAb production in the recovery from a flare-up of chronic immune thrombocytopenia (ITP) has been unknown. We here report the first retrospectively investigated case of serum anti-SARS-Cov-2 nAb production during chronic ITP flare-up triggered by COVID-19. A 79-year-old woman with a history of corticosteroid-refractory ITP visited our hospital complaining of fever, cough, and sore throat for 4 days. Although chronic ITP was controlled by 12.5 mg of eltrombopag (EPAG) every other day, laboratory tests showed a decreased peripheral blood platelet count of 15.0 × 10 9 /L, which indicated worsening thrombocytopenia. Meanwhile, PCR testing of a nasopharyngeal swab revealed that the patient was positive for SARS-Cov-2, and a computed tomography scan revealed bilateral pneumonia. On the basis of the flare-up of chronic ITP associated with COVID-19 pneumonia which was determined as a moderately severe status according to the WHO clinical progression scale, intravenous immunoglobulin therapy for 5 days (days 0–4) and antiviral therapy were added on top of EPAG, which only resulted in a transient increase in the platelet count for several days. After decreasing to 8.0 × 10 9 /L on day 13, the platelet count increased from day 16, coinciding with a positive detection for serum nAb against SARS-Cov-2. Although the increased dose up to 50 mg/day of EPAG was challenged during the clinical course, rapid dose reduction did not cause another relapse. In addition, no thrombotic or bleeding event was seen. These collectively suggest the vital role of the production of anti-SARS-Cov-2 nAb and improvement of clinical symptoms for recovery from a flare-up of chronic ITP in our case.

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SARS-CoV-2 infection-induced immune thrombocytopenia: a systematic review of current reports

Ono,

Kitagawa

2024

Ann Hematol

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Immune thrombocytopenia during the COVID‐19 pandemic

Cited by 9 publications

References 14 publications

Real‐world, single‐center experience of SARS‐CoV‐2 vaccination in immune thrombocytopenia

Real‐world, single‐center experience of SARS‐CoV‐2 vaccination in immune thrombocytopenia

Clinical Implication of the Effect of the Production of Neutralizing Antibodies Against SARS-Cov-2 for Chronic Immune Thrombocytopenia Flare-Up Associated with COVID-19 Infection: A Case Report and the Review of Literature

SARS-CoV-2 infection-induced immune thrombocytopenia: a systematic review of current reports

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