Elsaid Mohamed, Nune Arvind, Brakat Aml M, Anand Ayush, Alashwah Mahmoud, Maher Ahmed, Lama Nitu, Peñamante Criselle Angeline C
Faculty of Medicine, Misr University for Science and Technology, 6th of October, Giza, Egypt.
Medical Research Platform, Giza, Egypt.
Trop Dis Travel Med Vaccines. 2023 Nov 25;9(1):22. doi: 10.1186/s40794-023-00206-9.
The American Society of Haematology defines immune thrombocytopenic purpura (ITP) as a common hematologic disorder characterized by a transient or long-term decrease in platelet counts (< 100 × 109/L.), purpura, and haemorrhagic episodes caused by antiplatelet autoantibodies, with the exclusion of other clinical conditions. We aimed to systematically determine the incidence of ITP in adults and children following influenza vaccination, the duration between vaccination and the occurrence of ITP, and to identify predictors of ITP after the vaccine.
We searched PubMed, Cochrane Library, Google Scholar, Web of Science, Scopus, and Science Direct. We included primary studies that assessed the occurrence of immune thrombocytopenia in individuals who had received any influenza vaccine (primary or booster dose), regardless of the dosage, preparation, time of administration, or age of the participants. We excluded studies that were (a) Narrative, scoping, and umbrella reviews ;(b) studies with no accessible full text, abstract-only studies, or (c) Overlapping or unreliable data. The risk of bias in the included studies was assessed using the Joanna Briggs Institute (JBI) tool. We categorized studies for qualitative analysis based on study design. Descriptive statistics were used to summarize quantitative data, including the incidence of ITP after influenza vaccination.
Out of 729 articles retrieved from the database search, we included 24 studies. All patients identified and included in this systematic review presented with immune thrombocytopenia, determined by their platelet count. The period between vaccination and the occurrence of ITP ranged from (2:35 days). The mean duration was 13.5 days. The analysis revealed a statistically significant incidence rate ratio (IRR) = 1.85,95% CI [1.03-3.32] of ITP occurrence after 42 days.
Influenza-associated ITP is uncommon, self-limiting, non-life-threatening, and curable. None of the patients reported having severe adverse events or death. Further studies are required to confirm the exact incidence of the ITP to better understand the pathophysiology of ITP development post-influenza vaccination.
美国血液学会将免疫性血小板减少性紫癜(ITP)定义为一种常见的血液系统疾病,其特征为血小板计数短暂或长期减少(<100×10⁹/L)、紫癜以及由抗血小板自身抗体引起的出血发作,且排除其他临床情况。我们旨在系统地确定成人和儿童接种流感疫苗后ITP的发病率、接种疫苗与ITP发生之间的持续时间,并识别疫苗接种后ITP的预测因素。
我们检索了PubMed、Cochrane图书馆、谷歌学术、科学网、Scopus和科学Direct。我们纳入了评估接受过任何流感疫苗(首剂或加强剂量)的个体中免疫性血小板减少症发生情况的原始研究,无论剂量、制剂、给药时间或参与者年龄如何。我们排除了以下研究:(a)叙述性、范围界定性和综合性综述;(b)无法获取全文的研究、仅摘要的研究,或(c)重叠或不可靠的数据。使用乔安娜·布里格斯研究所(JBI)工具评估纳入研究的偏倚风险。我们根据研究设计对研究进行分类以进行定性分析。使用描述性统计来汇总定量数据,包括流感疫苗接种后ITP的发病率。
在从数据库搜索中检索到的729篇文章中,我们纳入了24项研究。所有在本系统评价中被识别并纳入的患者均表现出免疫性血小板减少症,这由他们的血小板计数确定。接种疫苗与ITP发生之间的时间间隔为(2至35天)。平均持续时间为13.5天。分析显示,42天后ITP发生的发病率比(IRR)具有统计学意义,为1.85,95%置信区间[1.03 - 3.32]。
流感相关的ITP并不常见,具有自限性,不危及生命且可治愈。没有患者报告有严重不良事件或死亡。需要进一步研究以确认ITP的确切发病率,以便更好地了解流感疫苗接种后ITP发生的病理生理学。