Thrombotic thrombocytopenic purpura: a new menace after COVID bnt162b2 vaccine

Abstract

Thrombotic thrombocytopenic purpura (TTP) is a known menace in hematology and is quite rare in practice with known triggers. Lately, in the COVID-19 pandemic, hematology has seen a new pathology amongst which TTP associated with COVID-19 messenger RNA (mRNA) vaccine is unique. We report a case of a 69-year-old male with multiple comorbidities who presented to the hospital with severe fatigue and shortness of breath. Labs were significant for thrombocytopenia, anemia, and hemolysis with schistocytes consistent with TTP with a second dose of BNT162b2 mRNA vaccine as a likely culprit been documented.

Thrombosis and thrombocytopenia in COVID-19 and after COVID-19 vaccination

“…Lately, a new pathologic insight of this unique hematologic disorder, TTP associated with COVID-19 mRNA vaccine, has been reported. Waqar et al [63] . suggested a possible presence of vaccinal antigens against ADAMTS13 specific gene responsible for creating a robust immune response.…”

Post COVID-19 vaccine deaths - Singapore’s early experience

“…The adverse side effects attributed to the mRNA vaccines have been widely reported, including acute local allergic reactions, systemic anaphylaxis, myocarditis and pericarditis. Rare cases of thrombotic thrombocytopenic purpura (TTP), initially reported in individuals who received viral vector vaccines, have also been reported in individuals inoculated with the Pfizer-BioNTech vaccine [41] , [42] , [43] . In Singapore, as of 30 June 2021, 6,606 suspected cases of vaccine-related adverse effects were reported, of which 252 were assessed as serious.…”

Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273

“…For VITT cases, thrombotic thrombocytopenic purpura (TTP) was a differential diagnosis. Several case reports had mentioned the development of TTP after vaccination, including BNT162b2 ( 10 , 11 ), ChAdOx1 ( 12 ), and Ad26.COV2-S ( 13 ). Diagnosis of TTP typically correlates with severely reduced ADAMTS13 activity.…”