接种 mRNA-SARS-CoV-2 疫苗后出现免疫性血小板减少性紫癜:一份病例报告

IF 0.4 Q4 NURSING Revista Cuidarte Pub Date : 2024-07-04 DOI:10.15649/cuidarte.3799
Heiler Lozada Ramos, R. Martínez-Vega, Liliana Torcoroma García
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引用次数: 0

摘要

亮点接种 mRNA 疫苗(BNT162b2 或 mRNA-1273)后出现自身免疫性疾病的病例。本报告介绍了一例接种 mRNA-SARS-CoV-2 后出现免疫性血小板减少性紫癜的病例,该病例以前没有血小板减少或其他血液病的报道。考虑到由于接种 COVID-19 疫苗,继发性 ITP 和其他血液病的发病率显著增加,接种疫苗后的血象检查可能是一项有用且费用低廉的随访措施:本文报告了一例哥伦比亚成年男性患者的病例,该患者既往没有血小板减少症或血液病的报告,却出现了轻度、慢性、无症状的免疫性血小板减少性紫癜,这是 SARS-CoV-2 m-RNA 后的一种罕见并发症。据我们所知,这是哥伦比亚首例与 mRNA 疫苗(BNT162b2 或 mRNA-1273)相关的免疫性血小板减少性紫癜病例,并进行了为期两年的全面临床随访。病例描述:患者于 2021 年 6 月接种了首剂和第二剂 mRNA BNT162b2 疫苗,2021 年 11 月接种了第一剂加强剂(mRNA-1273),2022 年 6 月接种了第二剂加强剂(mRNA BNT162b2)。在接种第二剂疫苗和两次加强剂后,血小板减少(血小板<100 x109/L,这是定义免疫性血小板减少性紫癜的标准)得到了记录,并在皮质类固醇治疗后得到了改善。然而,循环性血小板减少症一直持续到 2023 年 8 月的临床随访,血小板计数从 57 到 191 x109 个血小板/升不等(平均值:103 x109 个血小板/升)。结论 鉴于接种SARS-CoV-2 mRNA疫苗后可能出现继发性免疫性血小板减少性紫癜,因此应开展系统研究,确定与COVID-19免疫接种引起的免疫性血小板减少性紫癜相关的风险因素:Lozada Ramos Heiler, Martínez-Vega Ruth Aralí, García Liliana Torcoroma.接种 mRNA-SARS-CoV-2 疫苗后出现免疫性血小板减少性紫癜:病例报告。Revista Cuidarte.2024;15(2):e3799. https://doi.org/10.15649/cuidarte.3799
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Immune thrombocytopenic purpura following mRNA-SARS-CoV-2 vaccination: a case report
Highlights Cases of autoimmune diseases have been registered after vaccination with mRNA vaccines (BNT162b2 or mRNA-1273). A case of immune thrombocytopenic purpura following mRNA-SARS-CoV-2 without any previous reports of thrombocytopenia or other hematologic disorders is presented. The thrombocytopenia persisted and progressed to a chronic non-bleeding condition two years after the first vaccine dose administration, with episodes of temporary recovery of platelet counts. Considering that the incidence of secondary ITP and other hematological disorders has significantly increased due to COVID-19 vaccination, a post-vaccination hemogram check could be a useful and inexpensive follow-up measure. Introduction: Herein, it is presented a case report of a Colombian adult male patient, without any previous report of thrombocytopenia or hematological disorders, who developed a mild and chronic paucisymptomatic immune thrombocytopenic purpura, a rare complication following SARS-CoV-2 m-RNA. To the best of our knowledge, this represents the first documented case in Colombia of immune thrombocytopenic purpura associated with mRNA vaccines (BNT162b2 or mRNA-1273), with a comprehensive 2-year clinical follow-up. Case Description: The patient received the initial and second doses of the mRNA BNT162b2 vaccine in June 2021, the first booster dose in November 2021 (mRNA-1273), and the second booster dose (mRNA BNT162b2) in June 2022. Thrombocytopenia (<100 x109 platelets/L, which is the criterion to define immune thrombocytopenic purpura) was documented after the second vaccination dose and both boosters, and it improved after corticosteroid therapy. However, cycling thrombocytopenia persisted until the clinical follow-up in August 2023, with platelet count ranging from 57 to 191 x109 platelets/L (mean: 103 x109 platelets/L). Conclusion:  Given that secondary immune thrombocytopenic purpura can occur following SARS-CoV-2 mRNA vaccination, systematic research to identify risk factors associated with immune thrombocytopenic purpura due to COVID-19 immunization should be conducted. How to cite this article: Lozada Ramos Heiler, Martínez-Vega Ruth Aralí, García Liliana Torcoroma. Immune thrombocytopenic purpura following mRNA-SARS-CoV-2 vaccination: A case report. Revista Cuidarte. 2024;15(2):e3799.     https://doi.org/10.15649/cuidarte.3799
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来源期刊
Revista Cuidarte
Revista Cuidarte NURSING-
CiteScore
0.70
自引率
25.00%
发文量
53
审稿时长
19 weeks
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