key: cord-0976572-q3074kil
authors: Tarawneh, Omar; Tarawneh, Husam
title: Immune thrombocytopenia in a 22‐year‐old post Covid‐19 vaccine
date: 2021-02-11
journal: Am J Hematol
DOI: 10.1002/ajh.26106
sha: a971c6ffdf546f855af2f22c462aebc16f5b765d
doc_id: 976572
cord_uid: q3074kil

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He had no personal or family history of bleeding or autoimmune disease. Vital signs and the remainder of his exam were normal. Laboratory tests revealed normal white-cell count, hemoglobin, and severe thrombocytopenia with a platelet count of 2 × 10 9 /L. Two months prior to receiving the vaccine, the patient was evaluated at an outpatient clinic for upper respiratory symptoms. His PCR assay returned negative for SARS-CoV-2, and complete blood count was unremarkable with a normal platelet count of 145 × 10 9 /L (reference range, 140-400 × 10 9 /L). The upper respiratory symptoms resolved within a few days, and the patient had no further complaints.

However, as a precautionary measure, one-week post outpatient evaluation, he was again tested for SARS-CoV-2, which returned negative.

At the emergency department on day 3, post-vaccination, the following labs were normal or negative: prothrombin time, partial thromboplastin time, fibrinogen, BUN, creatine, electrolytes, bilirubin, LDH, alkaline phosphatase, albumin, globulin, total protein, and haptoglobin.

The aspartate aminotransferase (42) and alanine aminotransferase (90) were mildly elevated; however, they normalized the next day. Previous studies reported only mild or moderate adverse events following the Covid-19 vaccine. [2] [3] [4] To our knowledge, outside of a report in the press, 5,6 this is the first case published in the medical literature of an individual, with no other cause identified and no associated illness, experiencing ITP after receiving the Pfizer-BioNTech vaccine. The temporal relationship of the patient's presentation 3 days post-vaccine administration suggests, but does not prove, the vaccine may be linked to the patient's ITP. Additionally, the rapid and severe drop in platelet count to 2 × 10 9 /L is reminiscent of the abrupt onset F I G U R E 1 Purpuric lesions on the patient's upper extremity

American Society of Hematology 2019 guidelines for immune thrombocytopenia

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Doctor's death after Covid vaccine is being investigated. The New York Times

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Drug-induced thrombocytopenia: pathogenesis, evaluation, and management

The incidence of immune thrombocytopenic purpura in children and adults: a critical review of published reports

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