Blood Res.  2023 Jun;58(2):116-117. 10.5045/br.2023.2023036.

A case report of thrombotic thrombocytopenic purpura-like syndrome after Coronavirus disease 2019 vaccination

• Noh S
• Kim SA
• Lee JY
• Lee JO
• Bang SM

• KMID: 2543953
• DOI: http://doi.org/10.5045/br.2023.2023036

Figure

• 

  Fig. 1 Clinical course and changes in laboratory findings. With steroid treatment plus plasmapheresis, the patient’s hemoglobin levels and platelet counts recovered rapidly. Renal biopsy was performed during the administration of high-dose steroids.

• 

  Fig. 2 Light microscopy of the kidney biopsy. (A) Endothelial swelling and some intraglomerular thrombi were observed on H&E-stained specimens (×500). (B) Segmental occlusion of the glomerular capillary lumen and thickening of the shrunken capillary wall with double contours were observed using PAS staining (×400).

Reference

1. Chang JC. 2018; Hemostasis based on a novel 'two-path unifying theory' and classification of hemostatic disorders. Blood Coagul Fibrinolysis. 29:573–84. DOI: 10.1097/MBC.0000000000000765. PMID: 30063477.

2. Chang JC. 2018; TTP-like syndrome: novel concept and molecular pathogenesis of endotheliopathy-associated vascular microthrombotic disease. Thromb J. 16:20. DOI: 10.1186/s12959-018-0174-4. PMID: 30127669. PMCID: PMC6087012. PMID: 8b4620369a8147008e9312b9d9b56db5.

3. Tsai HM. 2010; Pathophysiology of thrombotic thrombocytopenic purpura. Int J Hematol. 91:1–19. DOI: 10.1007/s12185-009-0476-1. PMID: 20058209. PMCID: PMC3159000.

4. Chauhan AK, Goerge T, Schneider SW, Wagner DD. 2007; Formation of platelet strings and microthrombi in the presence of ADAMTS-13 inhibitor does not require P-selectin or beta3 integrin. J Thromb Haemost. 5:583–9. DOI: 10.1111/j.1538-7836.2007.02361.x. PMID: 17166247.

5. Dong JF, Moake JL, Nolasco L, et al. 2002; ADAMTS-13 rapidly cleaves newly secreted ultralarge von Willebrand factor multimers on the endothelial surface under flowing conditions. Blood. 100:4033–9. DOI: 10.1182/blood-2002-05-1401. PMID: 12393397.

6. Webster K, Schnitzler E. 2014; Hemolytic uremic syndrome. Handb Clin Neurol. 120:1113–23. DOI: 10.1016/B978-0-7020-4087-0.00075-9. PMID: 24365375.

7. Pavord S, Scully M, Hunt BJ, et al. 2021; Clinical features of vaccine-induced immune thrombocytopenia and thrombosis. N Engl J Med. 385:1680–9. DOI: 10.1056/NEJMoa2109908. PMID: 34379914.