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ChAdOx1 nCoV-19疫苗接种后免疫性血小板减少症1例报告

A Case Report of Immune Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination.

作者信息

Kim Gyungah, Choi Eun-Ji, Park Han-Seung, Lee Jung-Hee, Lee Je-Hwan, Lee Kyoo-Hyung

机构信息

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.

出版信息

J Korean Med Sci. 2021 Nov 8;36(43):e306. doi: 10.3346/jkms.2021.36.e306.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/367c/8575766/05c915a5da40/jkms-36-e306-g001.jpg

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