Semi-selective plasma filtration applied to the treatment of acquired thrombotic thrombocytopenic purpura following bnt162b2 administration.

Male Humans Middle Aged Purpura, Thrombotic Thrombocytopenic / chemically induced BNT162 Vaccine COVID-19 / therapy Plasma Exchange Anemia, Hemolytic / therapy
Anti SARS-CoV-2-vaccination Caplacizumab Microangiopathic hemolytic anemia Plasma filtration

Journal

Journal of nephrology
ISSN: 1724-6059
Titre abrégé: J Nephrol
Pays: Italy
ID NLM: 9012268

Informations de publication

Date de publication:
01 2023
Historique:
received: 19 04 2022
accepted: 06 07 2022
pubmed: 4 9 2022
medline: 7 2 2023
entrez: 3 9 2022
Statut: ppublish

Résumé

Following the widespread use of anti SARS-CoV-2 vaccines, there have been reports of thrombocytopenia developing after the administration of different types of vaccine. We report a case of a 63-year-old male who developed neurological symptoms after receiving the second dose of the bnt162b2 vaccine. Blood tests performed upon admission to the Emergency Department revealed severe thrombocytopenia and microangiopathic hemolytic anemia. ADAMTS13 activity was undetectable and antibody titer was high. Due to the rapid neurological deterioration, steroid therapy with prednisone was started at an initial dose of 1 mg/kg/day. Rituximab therapy was started to prevent the formation of new antibodies. Given the slow response to this therapy, we added Caplacizumab, (a monoclonal antibody anti-Von Willebrand factor) in order to inhibit platelet hyperaggregation, combined with standard plasma exchange. The patient experienced repeated episodes of intolerance to fresh frozen plasma (FFP). Switching from plasma exchange to plasma filtration, remission was attained in this unusual case of vaccine-related thrombocytopenia with microangiopathic hemolytic anemia.

Identifiants

DOI: 10.1007/s40620-022-01402-0 PMID: 36057036 PMC: PMC9440330
pubmed: 36057036
doi: 10.1007/s40620-022-01402-0
pii: 10.1007/s40620-022-01402-0
pmc: PMC9440330
doi:

Substances chimiques

BNT162 Vaccine 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

229-232

Informations de copyright

© 2022. The Author(s) under exclusive licence to Italian Society of Nephrology.

Références

Joly BS, Coppo P, Veyradier A (2017) Thrombotic thrombocytopenic purpura. Blood 129(21):2836–2846. https://doi.org/10.1182/blood-2016-10-709857
doi: 10.1182/blood-2016-10-709857
Page EE, Kremer Hovinga JA, Terrell DR, Vesely SK, George JN (2017) Thrombotic thrombocytopenic purpura: diagnostic criteria, clinical features, and long-term outcomes from 1995 through 2015. Blood Adv 1(10):590–600. https://doi.org/10.1182/bloodadvances.2017005124
doi: 10.1182/bloodadvances.2017005124
Bin WSH, Khan AA, Memon S (2021) Thrombotic thrombocytopenic purpura: a new menace after COVID bnt162b2 vaccine. Int J Hematol 114(5):626–629. https://doi.org/10.1007/s12185-021-03190-y
doi: 10.1007/s12185-021-03190-y
Kojima Y, Ohashi H, Nakamura T et al (2014) Acute thrombotic thrombocytopenic purpura after pneumococcal vaccination. Blood Coagul Fibrinolysis 25(5):512–514. https://doi.org/10.1097/MBC.0000000000000058
doi: 10.1097/MBC.0000000000000058
Maayan H, Kirgner I, Gutwein O et al (2021) Acquired thrombotic thrombocytopenic purpura: a rare disease associated with BNT162b2 vaccine. J Thromb Haemost 19(9):2314–2317. https://doi.org/10.1111/jth.15420
doi: 10.1111/jth.15420
Mohseni-Afshar Z, Babazadeh A, Janbakhsh A et al (2021) Vaccine-induced immune thrombotic thrombocytopenia after vaccination against Covid-19: a clinical dilemma for clinicians and patients. Rev Med Virol. https://doi.org/10.1002/rmv.2273
doi: 10.1002/rmv.2273
Arepally GM, Ortel TL (2021) Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know. Blood 138(4):293–298. https://doi.org/10.1182/blood.2021012152
doi: 10.1182/blood.2021012152
Perricone C, Ceccarelli F, Nesher G et al (2014) Immune thrombocytopenic purpura (ITP) associated with vaccinations: a review of reported cases. Immunol Res 60(2–3):226–235. https://doi.org/10.1007/s12026-014-8597-x
doi: 10.1007/s12026-014-8597-x
Alislambouli M, Victoria AV, Matta J, Yin F (2021) Acquired thrombotic thrombocytopenic purpura following Pfizer COVID-19 vaccination. EJHaem. https://doi.org/10.1002/jha2.342
doi: 10.1002/jha2.342
Padmanabhan A, Connelly-Smith L, Aqui N et al (2019) Guidelines on the Use of therapeutic apheresis in clinical practice - evidence-based approach from the writing committee of the american society for apheresis: the eighth special issue. J Clin Apher 34(3):171–354. https://doi.org/10.1002/jca.21705
doi: 10.1002/jca.21705
Zheng XL, Vesely SK, Cataland SR et al (2020) ISTH guidelines for treatment of thrombotic thrombocytopenic purpura. J Thromb Haemost 18(10):2496–2502. https://doi.org/10.1111/jth.15010
doi: 10.1111/jth.15010
Scully M, Cataland SR, Peyvandi F et al (2019) Caplacizumab treatment for acquired thrombotic thrombocytopenic purpura. N Engl J Med 380(4):335–346. https://doi.org/10.1056/nejmoa1806311
doi: 10.1056/nejmoa1806311
Scully M, Cataland SR, Peyvandi F, Coppo P, Knöbl P, Kremer Hovinga JA, Metjian A, de la Rubia J, Pavenski K, Callewaert F, Biswas D, De Winter H, Zeldin RK, HERCULES Investigators (2019) Caplacizumabtreatment for acquired thrombotic thrombocytopenic purpura. N Engl J Med 380(4):335–346. https://doi.org/10.1056/NEJMoa1806311 Epub 2019 Jan 9 PMID: 30625070
doi: 10.1056/NEJMoa1806311
Peyvandi F, Scully M, Kremer Hovinga JA, Knöbl P, Cataland S, De Beuf K, Callewaert F, WinterH De, Zeldin RK (2017) Caplacizumab reduces the frequency of major thromboembolic events, exacerbationsand death in patients with acquired thrombotic thrombocytopenic purpura. J Thromb Haemost 15(7):1448–1452. https://doi.org/10.1111/jth.13716 Epub 2017 Jun 5 PMID: 28445600
doi: 10.1111/jth.13716
Yoshida K, Sakaki A, Matsuyama Y et al (2022) Acquired thrombotic thrombocytopenic purpura following BNT162b2 mRNA coronavirus disease vaccination in a Japanese patient. Intern Med 61(3):407–412. https://doi.org/10.2169/internalmedicine.8568-21
doi: 10.2169/internalmedicine.8568-21
Kirpalani A, Garabon J, Amos K et al (2022) Thrombotic thrombocytopenic purpura temporally associated with BNT162b2 vaccination in an adolescent successfully treated with caplacizumab. Br J Haematol 196(1):e11–e14. https://doi.org/10.1111/bjh.17782
doi: 10.1111/bjh.17782

Auteurs

Roberta Fenoglio (R)

CMID-Nephrology and Dialysis Unit (ERK-Net Member), Center of Research of Immunopathology and Rare Diseases- Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences, University of Turin and San Giovanni Bosco Hub Hospital, Piazza del Donatore di Sangue 3, 10054, Turin, Italy.

Martina Marchisio (M)

CMID-Nephrology and Dialysis Unit (ERK-Net Member), Center of Research of Immunopathology and Rare Diseases- Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences, University of Turin and San Giovanni Bosco Hub Hospital, Piazza del Donatore di Sangue 3, 10054, Turin, Italy.

Alessandra Baffa (A)

CMID-Nephrology and Dialysis Unit (ERK-Net Member), Center of Research of Immunopathology and Rare Diseases- Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences, University of Turin and San Giovanni Bosco Hub Hospital, Piazza del Donatore di Sangue 3, 10054, Turin, Italy.

Giacomo Quattrocchio (G)

CMID-Nephrology and Dialysis Unit (ERK-Net Member), Center of Research of Immunopathology and Rare Diseases- Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences, University of Turin and San Giovanni Bosco Hub Hospital, Piazza del Donatore di Sangue 3, 10054, Turin, Italy.

Dario Roccatello (D)

CMID-Nephrology and Dialysis Unit (ERK-Net Member), Center of Research of Immunopathology and Rare Diseases- Coordinating Center of the Network for Rare Diseases of Piedmont and Aosta Valley, Department of Clinical and Biological Sciences, University of Turin and San Giovanni Bosco Hub Hospital, Piazza del Donatore di Sangue 3, 10054, Turin, Italy. dario.roccatello@unito.it.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Semi-selective plasma filtration applied to...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Semi-selective plasma filtration applied to...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations cutanées › Purpura › Purpura thrombopénique › Purpura thrombotique thrombocytopénique › Semi-selective plasma filtration applied to...
questionsmedicales.fr › Facteurs biologiques › Antigènes › Vaccins synthétiques › Vaccins à base d'acide nucléique › Vaccins à ARNm › Vaccin BNT162 › Semi-selective plasma filtration applied to...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Semi-selective plasma filtration applied to...
questionsmedicales.fr › Procédures de chirurgie opératoire › Circulation extracorporelle › Plasmaphérèse › Échange plasmatique › Semi-selective plasma filtration applied to...
questionsmedicales.fr › Hémopathies et maladies lymphatiques › Hémopathies › Anémie › Anémie hémolytique › Semi-selective plasma filtration applied to...