A Case of COVID-19 Vaccine-Induced Thrombotic Thrombocytopenia

COVID-19 vaccine and autoimmunity. A new case of autoimmune hepatitis and review of the literature

“…It has been suggested that portal infiltration with eosinophils correlates with drug-induced liver injury, including vaccines (i.e., Moderna mRNA-1273 and AstraZeneca ChAdOx1 nCoV-19 vaccines) [ 8 , 27 , 28 ]. This could partially explain the existence of hepatitis following vaccination without positivity for liver-associated autoantibodies ( Table 1 ) [ 8 , 10 , 12 , 13 , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] ].…”

“… Normal clotting times Negative hepatitis B virus surface antigen, anti- hepatitis C virus antibody, VIH, ANAS, dsDNA and urea breath test. Negative anti-heparin/platelet factor 4 IgG Chittal et al [ 50 ] Thrombotic Thrombocytopenia Moderna mRNA-1273 COVID-19 3 days after 2 dose Platelet count 65,000 platelets/mcL with further decline to 29,000 platelets/mcL Mildly elevated aPTT Positive lupus anticoagulant Positive anti-Platelet factor 4 Jawed et al [ 36 ] Flare acute immune thrombocytopenia Pfizer- BioNTech mRNA vaccine 18 Days after the first dose Platelet count 1000/mcL Peripheral smear thrombocytopenia and normal red blood cell morphology Reticulocyte count 2.2% Prothrombin time 16.2 secs INR 1.5 mg/dL, LDH 310 U/L Negative ANAs Gaignard et al [ 37 ] Acute immune thrombocytopenia Moderna mRNA-1273 COVID-19 Case 1 (IPT): 3 days after 1 dose Case 1: Platele...…”

Thrombocytopenia and pneumonitis associated with BNT16B2b2 mRNA COVID-19 vaccine: A case report

“…In contrast to pneumonia, many cases of thrombocytopenia without thrombosis associated with SARS-CoV-2 vaccines have been reported ( Table 2 ) ( Malayala et al, 2021 , Chittal et al, 2021 , Vaira et al, 2021 , Helms et al, 2021 , Thaler et al, 2021 , Akiyama et al, 2021 , Razzaq et al, 2021 , Wiedmann et al, 2021 , Idogun et al, 2021 , Qasim et al, 2021 , Lavin et al, 2021 ). Symptoms developed within a week of first-dose administration.…”

COVID-19 and antiphospholipid antibodies

“…Parallels among VITT, HIT, and APS have often been described, as all three are antibody-mediated processes associated with thromboembolic manifestations. Patients with VITT or HIT may be positive for aPL, although the clinical significance of aPL in these conditions is uncertain [ [110] , [111] , [112] , [113] ]. One study of 126 aPL-positive patients (89 with APS, 37 with asymptomatic aPL) who mostly received the Pfizer-BioNTech COVID-19 vaccine found anti-PF4 antibodies in 9 patients, with no significant change in anti-PF4 antibody titres before or after vaccination in either APS or asymptomatic aPL-positive patients [ 114 ].…”