Immune Thrombocytopenia Induced by the Chimpanzee Adenovirus-Vectored Vaccine against SARS-CoV-2 Infection

Liao, Po-Wei; Teng, Chieh‐Lin Jerry; Chou, Chia-Lin

doi:10.3390/vaccines9121486

Cited by 8 publications

(2 citation statements)

References 26 publications

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“…Considering platelet-autoantibodies have been found in both adenoviral vector and mRNA COVID-19 vaccine recipients [ 21 , 22 , 23 ], but not healthy individuals [ 8 , 24 ], we examined the association between the (type of) vaccine(s) and the presence of platelet-autoantibodies. We found that the risk of developing antibodies was independent of the (type of) vaccine and we therefore concluded there is no association between the (type of) vaccine or the presence of platelet-antibodies in clinically suspected VITT patients.…”

Section: Discussionmentioning

confidence: 99%

Antibodies against Platelet Glycoproteins in Clinically Suspected VITT Patients

Meier,

Porcelijn,

Hofstede-van Egmond

et al. 2024

Antibodies

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Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare but severe complication following COVID-19 vaccination, marked by thrombocytopenia and thrombosis. Analogous to heparin-induced thrombocytopenia (HIT), VITT shares similarities in anti-platelet factor 4 (PF4) IgG-mediated platelet activation via the FcγRIIa. To investigate the involvement of platelet-antibodies in VITT, we analyzed the presence of platelet-antibodies directed against glycoproteins (GP)IIb/IIIa, GPV and GPIb/IX in the serum of 232 clinically suspected VITT patients determined based on (suspicion of) occurrence of thrombocytopenia and/or thrombosis in relation to COVID-19 vaccination. We found that 19% of clinically suspected VITT patients tested positive for anti-platelet GPs: 39%, 32% and 86% patients tested positive for GPIIb/IIIa, GPV and GPIb/IX, respectively. No HIT-like VITT patients (with thrombocytopenia and thrombosis) tested positive for platelet-antibodies. Therefore, it seems unlikely that platelet-antibodies play a role in HIT-like anti-PF4-mediated VITT. Platelet-antibodies were predominantly associated with the occurrence of thrombocytopenia. We found no association between the type of vaccination (adenoviral vector vaccine versus mRNA vaccine) or different vaccines (ChAdOx1 nCoV-19, Ad26.COV2.S, mRNA-1273, BTN162b2) and the development of platelet-antibodies. It is essential to conduct more research on the pathophysiology of VITT, to improve diagnostic approaches and identify preventive and therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Antibodies against Platelet Glycoproteins in Clinically Suspected VITT Patients

Meier,

Porcelijn,

Hofstede-van Egmond

et al. 2024

Antibodies

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“…The onset of vaccine-related ITP usually has a time relationship, occurring mainly within 42 days after vaccination [5] . Since the beginning of the COVID-19 mass immunization campaign, several case-reports or case-series of ITP following vaccination have been described in the literature [5] , [6] , [7] , [8] . In some cases, underlying autoimmune medical conditions may have contributed to the ITP occurrence but it appears infrequent [8] .…”

Section: Discussionmentioning

confidence: 99%

Immune thrombocytopenia following ChAdOx1 vaccine and positive rechallenge with BNT162b2 vaccine: A case report with pharmacovigilance analysis

et al. 2023

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COVID‐19‐induced immune thrombocytopenia management approach: A case report and literature review

Alahwal,

Alsharif,

Alsharif

et al. 2024

Clinical Case Reports

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Key Clinical MessageVincristine therapy can be effective in refractory Immune thrombocytopenia (ITP) following COVID‐19 vaccination. Our case report highlights the need for further research to establish standard management guidelines for COVID‐19‐vaccine‐associated ITP.AbstractAdult immune thrombocytopenia (ITP) can occur as a rare complication following several viral infections or a rare adverse event or complication of vaccination. In this paper, we report a case of a 39‐year‐old male patient with severe refractory ITP that began 4‐weeks after receiving his third (booster) dose of the COVID‐19 vaccine (BNT162b2, Pfizer‐BioNTech). He was given oral dexamethasone 40 mg daily for 4 days followed by prednisone at 1 mg/kg (85 mg daily) for 10 days. In the following weeks, we attempted several other lines of therapy to treat his ITP, including anti‐RhD immunoglobulin, which, unfortunately, caused moderate hemolysis requiring packed red blood cell transfusion, intravenous immunoglobulin (given at a subtherapeutic dose of 0.4 g/kg for only 1 day since it was not available), rituximab, and eltrombopag. The patient, unfortunately, showed no response to any of these treatments. This was an indicator to initiate salvage therapy with vincristine 2 mg weekly for 3 weeks. The patient's platelet count started to increase remarkably during the third week of vincristine and normalized after 4 weeks. We review the findings, clinical characteristics, and management approaches that were reported in the literature regarding COVID‐19‐vaccine‐induced ITP. More in‐depth research is needed to delineate standard guidelines for the management of such cases. This report underscores the importance of resorting to vincristine and eltrombopag as great options for severe and refractory ITP related to the COVID‐19 vaccine.

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Immune Thrombocytopenia Induced by the Chimpanzee Adenovirus-Vectored Vaccine against SARS-CoV-2 Infection

Cited by 8 publications

References 26 publications

Antibodies against Platelet Glycoproteins in Clinically Suspected VITT Patients

Antibodies against Platelet Glycoproteins in Clinically Suspected VITT Patients

Immune thrombocytopenia following ChAdOx1 vaccine and positive rechallenge with BNT162b2 vaccine: A case report with pharmacovigilance analysis

COVID‐19‐induced immune thrombocytopenia management approach: A case report and literature review

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