Coincidental or causal? A case report of acquired thrombotic thrombocytopenic purpura following mRNA-1273 Covid-19 vaccination

Mekheal, Erinie; Millet, Christopher; Mekheal, Nader; Ghrewati, Moutaz; Mechineni, Ashesha; Maroules, Michael

doi:10.1016/j.htct.2022.09.1278

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…A total of 84 cases of TMA associated with COVID‐19 vaccination were found in 58 articles, 2,9–65 including 64 patients diagnosed with TTP (Table 1), 17 cases manifested as aHUS (Table 2, cases 1–17), and three patients presented as unclassified TMA (Table 2, cases 18–20). Subsequently, relevant clinical records were extracted for analysis, including baseline characteristics, laboratory tests, treatment options, and outcomes.…”

Section: Clinical Characteristics Of Tma Patients Associated With Cov...mentioning

confidence: 99%

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New‐onset and relapsed thrombotic microangiopathy post‐COVID‐19 vaccination

2023

Journal of Medical Virology

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Thrombotic microangiopathy (TMA) associated with coronavirus disease 2019 (COVID-19) vaccination has been reported, however, the clinical characteristics and pathogenesis remained mysterious. We reviewed 84 TMA cases post-COVID-19 vaccination, including 64 patients diagnosed with thrombotic thrombocytopenic purpura (TTP), 17 cases presented as atypical hemolytic uremic syndrome (aHUS), and three cases manifested as unclassified TMA. TMA episodes were mostly associated with messenger RNA vaccines. For TTP, 67.6% of females developed symptoms after the first dose of the vaccine, and 63.0% of males were secondary to the second dose (p = 0.015). Compared with TTP, aHUS generally appeared within 7 days (p = 0.002) and showed higher levels of serum creatinine (p < 0.001). 87.5% of TTP received plasma exchange (PEX)-based treatment, and 52.9% of aHUS adopted non-PEX-based therapies (p < 0.001). Mechanistically, complement dysfunction, neutrophil activation, and the generation of pathogenic autoantibodies resulting from molecular mimicry contribute to explaining the pathogenesis of TMA post-COVID-19 vaccination.

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Section: Clinical Characteristics Of Tma Patients Associated With Cov...mentioning

confidence: 99%

“…There were 64 affected individuals presented as TTP (Table 1), 2,9–49 including 44 newly diagnosed (68.8%) and 20 relapsed (31.3%). The median age was 49.5 (14–84) years.…”

Section: Clinical Characteristics Of Tma Patients Associated With Cov...mentioning

confidence: 99%