Journal
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
Volume 19, Issue 9, Pages 2314-2317Publisher
WILEY
DOI: 10.1111/jth.15420
Keywords
ADAMTS-13; acquired thrombotic thrombocytopenic purpura; autoimmunity; BNT162b2 vaccine; SARS-CoV-2
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This study presents a case series of patients who developed acquired Thrombotic Thrombocytopenic Purpura shortly after receiving the BNT162b2 vaccine. It recommends evaluating ADAMTS13 activity in patients with a history of aTTP before and after vaccination, especially with the SARS-CoV-2 vaccine. Close monitoring of patients' clinical situation and laboratory data post-vaccination is essential.
Background In December 2020 the Israeli Health Ministry began a mass vaccination campaign with the BNT162b2 vaccine. This was an important step in overcoming the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) pandemic. Autoimmune phenomenon have been described after receiving vaccinations. Patients/Methods Here we describe a case series of patients who developed acquired Thrombotic Thrombocytopenic Purpura, a rare autoimmune disease, within several days of receiving the BNT162b2 vaccine. Conclusions A disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 (ADAMTS13) activity should be evaluated in patients with history of aTTP before and after any vaccination, especially the SARS-CoV-2 vaccination, and immunosuppression treatment should be considered before vaccination in cases of low ADAMTS13 activity. Patients should be closely monitored after the vaccine for clinical situation and laboratory data. Post vaccination thrombocytopenia assessment should include immune thrombocytopenic purpura, vaccine-induced immune thrombotic thrombocytopenia and acquired thrombotic thrombocytopenic purpura.
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