Department of Emergency Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Division of Pulmonology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Am J Emerg Med. 2022 Jun;56:395.e1-395.e3. doi: 10.1016/j.ajem.2022.03.030. Epub 2022 Mar 18.
Safe and effective prophylactic vaccines are urgently needed to contain the coronavirus disease 2019 (COVID-19) pandemic. However, several vaccination-related adverse effects have been reported. Here, we report a rare case of severe immune thrombocytopenia occurring 3 days after receiving the mRNA-1273 (Moderna) COVID-19 vaccine in an Asian woman with a history of refractory lung adenocarcinoma treated with durvalumab, an immune checkpoint inhibitor. Treatment with platelet transfusion (12 units) and oral prednisolone (1 mg/kg per day) significantly improved her hemoptysis with thrombocytopenia. To the best of our knowledge, this is the first case of ITP following Moderna inoculation among Asians. This study highlights a potential adverse effect of mRNA-based COVID-19 vaccines in cancer patients receiving immune checkpoint inhibitors.
急需安全有效的预防性疫苗来控制 2019 年冠状病毒病（COVID-19）大流行。然而，已经报告了几种与疫苗接种相关的不良反应。在这里，我们报告了一例亚洲妇女在接受 durvalumab（一种免疫检查点抑制剂）治疗难治性肺腺癌后，接种 mRNA-1273（Moderna）COVID-19 疫苗 3 天后发生严重免疫性血小板减少症的罕见病例。血小板输注（12 单位）和口服泼尼松龙（1mg/kg/天）治疗显著改善了她的血小板减少性咯血。据我们所知，这是亚洲人中首例接受 Moderna 接种后发生 ITP 的病例。本研究强调了在接受免疫检查点抑制剂治疗的癌症患者中，基于 mRNA 的 COVID-19 疫苗的潜在不良反应。
