J Korean Med Sci.  2021 Nov;36(43):e306. 10.3346/jkms.2021.36.e306.

A Case Report of Immune Thrombocytopenia after ChAdOx1 nCoV-19 Vaccination

• Kim G
• Choi EJ
• Park HS
• Lee JH
• Lee JH
• Lee KH

• KMID: 2522290
• DOI: http://doi.org/10.3346/jkms.2021.36.e306

Abstract

Immune thrombocytopenia (ITP) is an autoimmune condition characterized by platelet destruction through antibody-mediated mechanism. ITP is one of the manifestations of a coronavirus disease, as well as an adverse event occurring after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several cases of ITP have been described after vaccination with two mRNA-based vaccines—BTN162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna)—against SARS-CoV-2. Herein, we report a case of ITP occurring after vaccination with ChAdOx1 adenovirus vector nCoV-19 (AstraZeneca) vaccine in Korea. A 66-year-old woman presented with multiple ecchymoses on both upper and lower extremities and gingival bleeding, appearing 3 days after receiving the first dose of ChAdOx1 nCoV-19. Her laboratory results showed isolated severe thrombocytopenia without evidence of combined coagulopathy. She was diagnosed with ITP and successfully treated with high-dose dexamethasone and intravenous immunoglobulin. Clinical suspicion to identify vaccinerelated ITP is important to promptly initiate appropriate treatment.

Keyword

COVID-19; SARS-CoV-2; ChAdOx1 nCoV-19; Immune Thrombocytopenia

Figure

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  Fig. 1 Ecchymoses and purpura observed on the patient's extremities and back.

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  Fig. 2 Clinical course and treatment scheme. Symptoms appeared 2 days after the first dose of ChAdOx1 nCoV-19 vaccine, and platelet counts improved after treatment with dexamethasone and IVIG.IVIG = intravenous immunoglobulin.

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