Refractory immune TTP following Pfizer-BioNTech COVID-19 vaccine successfully salvaged with caplacizumab.
J Thromb Haemost
; 20(7): 1696-1698, 2022 07.
Article
in English
| MEDLINE | ID: covidwho-1819920
ABSTRACT
Immune thrombotic thrombocytopenic purpura (iTTP) is a life-threatening thrombotic microangiopathy caused by antibodies against ADAMTS13. We report a young, healthy female who developed hematuria, vomiting, and hematemesis 3 weeks after her first dose of Pfizer Bio-NTech COVID-19 vaccine. Investigations confirmed iTTP with undetectable ADAMTS13 activity and a positive antibody assay. Despite initial response to standard treatment with plasma exchange and corticosteroids, she had an acute deterioration of her TTP with neurological and cardiac involvement. Fortunately, she then had prompt response to rituximab and emergently obtained caplacizumab and is now in remission. Although most cases of iTTP are of unknown etiology, we cannot exclude that her almost fatal iTTP episode was triggered by the Pfizer-BioNTech COVID-19 vaccine. This case also highlights the ability of caplacizumab to quickly halt disseminated thrombus formation in refractory TTP.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Purpura, Thrombotic Thrombocytopenic
/
Purpura, Thrombocytopenic, Idiopathic
/
Single-Domain Antibodies
/
COVID-19
Type of study:
Case report
/
Etiology study
Topics:
Vaccines
Limits:
Female
/
Humans
Language:
English
Journal:
J Thromb Haemost
Journal subject:
Hematology
Year:
2022
Document Type:
Article
Affiliation country:
Jth.15751
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