Researchers presented the rare case of a patient who developed vaccine-induced immune thrombocytopenia (ITP) and thrombosis (VITT) after receiving their second dose of the coronavirus disease 2019 (COVID-19) vaccine.
The patient was managed with high-dose intravenous dexamethasone, intravenous immunoglobulins, and apixaban to reverse the autoimmune process.
Read more about the clinical features of ITP
The case report is published in Cureus.
“Our case highlights the importance of the timely recognition and management of post-vaccine complications,” the authors of the study wrote. “Despite high mortality and more augments in favor of the causal relationship between the COVID-19 vaccine and VITT, timely diagnosis and management can be lifesaving.”
The case was that of a 28-year-old female who presented to the hospital with worsening severe headache, generalized fatigue, body rash, and neurological deficits 12 days after receiving a second dose of the ChAdOx1 COVID-19 vaccine. She had no previous medical history or family history of any thrombotic events.
Blood tests revealed that she had thrombocytopenia with deranged clotting time and elevated D-dimer levels. A computed tomography scan showed cerebral vasogenic edema and thrombosis in the left transverse sinus. Based on these findings, she was diagnosed with VITT, a rare but fatal complication of the COVID-19 vaccine as well as other vaccines including measles, mumps, rubella, human papillomavirus (HPV), hepatitis B, and poliovirus.
Following treatment, the patient’s condition gradually improved over 10 days, and she was discharged from the hospital after 2 weeks with an almost-complete resolution of her neurological deficits.
ITP is an autoimmune disease characterized by the immune system mistakenly attacking platelets, leading to an increased risk of bleeding from the skin, mucosa, gastrointestinal tract, and other organs.
ITP can be acute or chronic. Acute ITP can be caused by a viral infection or, in rare cases, a vaccination.
Reference
Kataria S, Reza RR, Agboola AA, et al. Immune thrombocytopenia and cerebral venous sinus thrombosis following COVID-19 vaccination: a case report. Cureus. Published online January 27, 2023. doi:10.7759/cureus.34272
