Kim Gyungah, Choi Eun-Ji, Park Han-Seung, Lee Jung-Hee, Lee Je-Hwan, Lee Kyoo-Hyung
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Korean Med Sci. 2021 Nov 8;36(43):e306. doi: 10.3346/jkms.2021.36.e306.
Immune thrombocytopenia (ITP) is an autoimmune condition characterized by platelet destruction through antibody-mediated mechanism. ITP is one of the manifestations of a coronavirus disease, as well as an adverse event occurring after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several cases of ITP have been described after vaccination with two mRNA-based vaccines-BTN162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)-against SARS-CoV-2. Herein, we report a case of ITP occurring after vaccination with ChAdOx1 adenovirus vector nCoV-19 (AstraZeneca) vaccine in Korea. A 66-year-old woman presented with multiple ecchymoses on both upper and lower extremities and gingival bleeding, appearing 3 days after receiving the first dose of ChAdOx1 nCoV-19. Her laboratory results showed isolated severe thrombocytopenia without evidence of combined coagulopathy. She was diagnosed with ITP and successfully treated with high-dose dexamethasone and intravenous immunoglobulin. Clinical suspicion to identify vaccine-related ITP is important to promptly initiate appropriate treatment.
免疫性血小板减少症(ITP)是一种自身免疫性疾病,其特征是通过抗体介导的机制破坏血小板。ITP是冠状病毒病的表现之一,也是接种严重急性呼吸综合征冠状病毒2(SARS-CoV-2)疫苗后发生的不良事件。在用两种基于mRNA的疫苗——BNT162b2(辉瑞-BioNTech)和mRNA-1273(Moderna)——接种SARS-CoV-2疫苗后,已有多例ITP病例被描述。在此,我们报告一例在韩国接种ChAdOx1腺病毒载体新冠疫苗(阿斯利康)后发生的ITP病例。一名66岁女性在接种第一剂ChAdOx1新冠疫苗3天后,双上肢和双下肢出现多处瘀斑及牙龈出血。她的实验室检查结果显示单纯严重血小板减少,无合并凝血功能障碍的证据。她被诊断为ITP,并通过大剂量地塞米松和静脉注射免疫球蛋白成功治疗。临床怀疑以识别疫苗相关的ITP对于及时启动适当治疗很重要。