ChAdOx1 nCoV-19 associated thrombocytopenia
Keywords:
ChAdOx1 nCoV-19, immune thrombocytopenia, vaccine เอกสารอ้างอิงAbstract
Nowadays, there is an incidence report of thrombocytopenia after vaccination with ChAdOx1 nCoV-19 in three countries: Scotland, Australia, and Thailand. In Thailand, the proportion of this incident is 16.8 per 100,000 cases per year, which is higher than the incidence in the general population.
Objective: To study the symptoms and response to treatment with thrombocytopenia after ChAdOx1 nCoV-19 vaccination. Descriptive study.
Methods: The researcher reviewed medical records of thrombocytopenia after vaccination with ChAdOx1 nCoV-19 who had been treated at Nakhonpathom hospital since 1 April 2021 - 30 August 2022.
Results: There are 3 cases in Nakhonpathom Hospital where thrombocytopenia occurred within 6 weeks after the ChAdOx1 nCoV-19 vaccination. First case, 43 years old male receives ITP (immune thrombocytopenia) treatment and does not respond turns to refractory ITP and plan splenectomy. Another 2 cases, 52 old female and 44 years old male receive ITP treatment and achieved complete response after 9 weeks and 4 weeks of cyclosporin respectively. During the study period from June 2021 – January 2022, the population in Nakhonpathom Province had the first injection of Az at 378,773 doses. Two ITP vaccine-induced cases were severe, treated after 4 weeks, and one was unresponsive.
Conclusion: All 3 cases involved severe need admission and no response to corticosteroid treatment
References
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from with pneumonia in China, 2019. N Engl J Med. 2020;382:727–33.
Wiersinga WJ, Rhodes A, Cheng AC, et al. Pathophysiology, transmission, diagnosis, and treatment of coronavirus Disease 2019 (COVID-19): A Review. 2020;324(8):782–93.
Black C, Kaye JA, Jick H. MMR vaccine and idiopathic thrombocytopaenic purpura. Br J ClinPharmacol. 2003;55(1):107–11.
Rajantie J, Zeller B, Treutiger I, et al. Vaccination associated thrombocytopenic purpura in children. Vaccine. 2007;25(10):1838–40.
France EK, Glanz J, Xu S, et al. Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children. Pediatrics. 2008;121(3):687–92.
Di Pietrantonj C, Rivetti A, Marchione P, et al. Vaccines for measles, mumps, rubella, and varicella in children. Cochrane Database Syst Rev. 2020;4(4):CD004407.
O'Leary ST, Glanz JM, McClure DL, Akhtar A, Daley MF, Nakasato C, et al. The risk of immune thrombocytopenic purpura after vaccination in children and adolescents. Pediatrics 2012;129:248-55.
Uaprasert N, Panrong K, Rojnuckarin P, et al. Thromboembolic and hemorrhagic risks after vaccination against SARS-CoV-2: a systematic review and meta-analysis of randomized controlled trials. Thromb J. 2021;19(1):86.
Lee EJ, Cines DB, Gernsheimer T, et al. Thrombocytopenia following Pfizer and Moderna SARS-CoV-2 vaccination. Am J Hematol. 2021;96(5):534–7.
Hippisley-Cox J, Patone M, Mei XW, et al. Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study. BMJ 2021;374:n1931.
Candelli M, Rossi E, Valletta F, et al. Immune thrombocytopenic purpura after SARS-CoV-2 vaccine. Br J Haematol. 2021;194(3):547-9.
Paulsen FO, Schaefers C, Langer F, et al. Immune thrombocytopenic purpura after vaccination with COVID-19 vaccine (ChAdOx1nCov-19). Blood. 2021;138(11):996–9.
Simpson CR, Shi T, Vasileiou E, et al. First-dose ChAdOx1 and BNT162b2 COVID-19 vaccines and thrombocytopenic, thromboembolic and hemorrhagic events in Scotland. Nat Med. 2021;27(7):1290–7.
Gordon SF, Clothier HJ, Morgan H, et al. Immune thrombocytopenia following immunisation with VaxzevriaChadx1-S (AstraZeneca) vaccine, Victoria, Australia. Vaccine. 2021;39:7052–7.
Uaprasert N, Panrong K, Tungjitviboonkun S, et al. ChAdOx1nCoV-19vaccine-associated thrombocytopenia: three cases of immune thrombocytopenia after 107 720 doses of ChAdOx1 vaccination in Thailand. Blood Coagul Fibrinolysis 2022;33:67-70.
Uaprasert N, Panrong K, Rojnuckarin P, Chiasakul T. Thromboembolic and hemorrhagic risks after vaccination against SARS-CoV-2: a systematic review and meta-analysis of randomized controlled trials. Thromb J 2021;19:86.
Lee EJ, Cines DB, Gernsheimer T, Kessler C, Michel M, Tarantino MD, et al Thrombocytopenia following Pfizer and Moderna SARS-CoV-2 vaccination. Am J Hematol2021;96:534-7.
Rinaldi M, Perricone C, Ortega-Hernandez OD, et al. Immune thrombocytopaenic purpura: an autoimmune cross-link between infections and vaccines. Lupus. 2014;23(6):554–67.
Karabulut K, Andronikashvili A, Kapici AH. Recurrence of thrombotic thrombocytopenic purpura after mRNA-1273 COVID-19 vaccine administered shortly after COVID-19. Case Rep Hematol. 2021;4130138.
Downloads
Published
Versions
- 2023-01-05 (2)
- 2022-12-29 (1)
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
