Lee Seul Bi, Park Chi Young, Park Sang-Gon, Lee Hee Jeong
Department of Internal Medicine, Hemato-oncology, Chosun University Hospital, Gwangju 501-717, South Korea.
World J Clin Cases. 2022 Nov 26;10(33):12268-12277. doi: 10.12998/wjcc.v10.i33.12268.
Following the global outbreak of coronavirus disease 2019 (COVID-19), unlike other vaccines, COVID-19 vaccines were developed and commercialized in a relatively short period of time. The large-scale administration of this vaccine in a short time-period led to various unexpected side effects, including severe cytopenia and thrombosis with thrombocytopenia syndrome. Despite many reports on adverse reactions, vaccination was necessary to prevent the spread of COVID-19; thus, it is essential to understand and discuss various cases of adverse reactions after vaccination.
A 77-year-old woman was administered the second dose of Pfizer mRNA COVID-19 vaccine. After vaccination she experienced fever, myalgia, and weakness. Antibiotics were subsequently administered for several days, but there was no improvement in the symptoms. The patient showed severe thrombocytopenia and leukocytosis. Thoracic and abdominopelvic computed tomography showed no infection related findings, but splenomegaly and cirrhotic liver features were observed. A large number of immature cells were observed in the peripheral blood smear; thus, bone marrow examination was performed for acute leukemia. However, there were no abnormalities. The patient recovered after administration of hepatotoxins and transfusion treatment for cytopenia and was diagnosed with an adverse reaction to COVID-19 vaccination.
Adverse reactions of vaccination could be mistaken for hematologic malignancies including leukemia. We report a patient with leukocytosis following COVID-19 vaccination.
2019年冠状病毒病(COVID-19)全球大流行后,与其他疫苗不同,COVID-19疫苗在相对较短的时间内研发并商业化。在短时间内大规模接种该疫苗导致了各种意想不到的副作用,包括严重血细胞减少和血小板减少伴血栓形成综合征。尽管有许多关于不良反应的报道,但接种疫苗对于预防COVID-19传播是必要的;因此,了解和讨论接种疫苗后的各种不良反应病例至关重要。
一名77岁女性接种了第二剂辉瑞mRNA COVID-19疫苗。接种后,她出现发热、肌痛和乏力。随后使用抗生素治疗了几天,但症状没有改善。患者出现严重血小板减少和白细胞增多。胸部和腹部盆腔计算机断层扫描未发现感染相关表现,但观察到脾肿大和肝硬化特征。外周血涂片观察到大量幼稚细胞;因此,对急性白血病进行了骨髓检查。然而,未发现异常。患者在使用肝毒素并针对血细胞减少进行输血治疗后康复,被诊断为对COVID-19疫苗接种的不良反应。
疫苗接种不良反应可能被误诊为包括白血病在内的血液系统恶性肿瘤。我们报告了一名COVID-19疫苗接种后出现白细胞增多的患者。