Postinfluenza Vaccination Idiopathic Thrombocytopenic Purpura in Three Elderly Patients

Abstract

The etiologies of secondary idiopathic thrombocytopenic purpura (ITP) include infection, autoimmune disease, and immunodeficiency. We report the cases of three elderly patients who developed ITP after receiving influenza vaccinations. The platelet count of an 81-year-old woman fell to 27,000/μL after she received an influenza vaccination. A 75-year-old woman developed thrombocytopenia (5,000 platelets/μL) after receiving an influenza vaccination. An 87-year-old woman whose laboratory test values included a platelet count of 2,000/μL experienced genital bleeding after receiving an influenza vaccination. After Helicobacter pylori (HP) eradication or corticosteroid treatment, all of the patients' platelet counts increased. Influenza vaccination is an underlying etiology of ITP in elderly patients. HP eradication or corticosteroid treatment is effective for these patients. Clinicians should be aware of the association between ITP and influenza vaccinations.

Influenza Vaccination-associated Acute Thrombocytopenia and Diffuse Alveolar Hemorrhage

“…In the present case, it was difficult to differentiate alternative causes of thrombocytopenia including ITP, as the performable examinations were limited by the patient's severe condition. Given the very short la- The pathogenesis of vaccine-related thrombocytopenia has not been completely elucidated, but influenza vaccination can trigger secondary ITP (3,(5)(6)(7). The onset of vaccinerelated ITP has a strict time relationship, developing within 4-35 days after influenza vaccination (4,7).…”

“…Given the very short la- The pathogenesis of vaccine-related thrombocytopenia has not been completely elucidated, but influenza vaccination can trigger secondary ITP (3,(5)(6)(7). The onset of vaccinerelated ITP has a strict time relationship, developing within 4-35 days after influenza vaccination (4,7). Treatment with glucocorticoids can be stopped in most reported cases of vaccine-related ITP (6)(7)(8)(9).…”

“…The onset of vaccinerelated ITP has a strict time relationship, developing within 4-35 days after influenza vaccination (4,7). Treatment with glucocorticoids can be stopped in most reported cases of vaccine-related ITP (6)(7)(8)(9). By contrast, 80% of patients with primary ITP develop chronic ITP (persistent for more than 1 year), necessitating additional therapies (10).…”

TxA 2 Receptor‐Based Vaccination: A Novel Potential Therapeutic Approach to Limit Thrombosis

“…The reported evidence suggests that vaccination often modulates platelets and other blood cell counts 14, 15. One would thus expect a similar effect of TPR vaccine on blood cells.…”

From influenza infection to anti-ADAMTS13 autoantibodies via cross-reactivity

“…Therefore, it assumes a scientific relevance the clinical observation by Kosugi et al [10], that influenza infection triggers TTP by producing anti-ADAMTS13 IgGs. The observation is crucial in light of the fact that the association between influenza infection and TTP is clinically well known [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29], so making feasible the hypothesis that the anti-influenza immune responses that follow influenza infection may cross-react with ADAMTS13 protein thus generating anti-ADAMTS13 AAbs. To prove or disprove the cross-reactivity hypothesis, the present study analyzed the peptide commonality between influenza virus and ADAMTS13 proteins since, actually, peptide sharing can lead to autoimmunity through cross-reactivity phenomena following pathogen infection.…”