Severe immune thrombocytopenia following COVID-19 vaccination (Moderna) and immune checkpoint inhibitor

Safe and effective prophylactic vaccines are urgently needed to contain the coronavirus disease 2019 (COVID-19) pandemic. However, several vaccination-related adverse effects have been reported. Here, we report a rare case of severe immune thrombocytopenia occurring 3 days after receiving the mRNA-1...

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Bibliographic Details
Published inThe American journal of emergency medicine Vol. 56; pp. 395.e1 - 395.e3
Main Authors Chong, Kah-Meng, Yang, Ching-Yao, Lin, Chien-Chin, Lien, Wan-Ching
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.06.2022
Elsevier Limited
Subjects
Adenocarcinoma
Asian people
Blood platelets
Cancer vaccines
Coronaviruses
COVID-19
COVID-19 vaccines
COVID-19 Vaccines - adverse effects
Emergency medical care
Female
Hemoptysis
Hepatitis
Humans
Idiopathic thrombocytopenic purpura
Immune Checkpoint Inhibitors
Immune thrombocytopenia
Immunotherapy
Inoculation
Lung cancer
Moderna vaccine
Monoclonal antibodies
mRNA
mRNA-based vaccine
Pandemics
Patients
Prednisolone
Purpura, Thrombocytopenic, Idiopathic - chemically induced
Purpura, Thrombocytopenic, Idiopathic - drug therapy
Side effects
Targeted cancer therapy
Thrombocytopenia
Thrombocytopenia - chemically induced
Vaccination - adverse effects
Vaccines
United States > US
COVID-19
Moderna vaccine
Immune checkpoint inhibitors
mRNA-based vaccine
Immune thrombocytopenia
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Summary:Safe and effective prophylactic vaccines are urgently needed to contain the coronavirus disease 2019 (COVID-19) pandemic. However, several vaccination-related adverse effects have been reported. Here, we report a rare case of severe immune thrombocytopenia occurring 3 days after receiving the mRNA-1273 (Moderna) COVID-19 vaccine in an Asian woman with a history of refractory lung adenocarcinoma treated with durvalumab, an immune checkpoint inhibitor. Treatment with platelet transfusion (12 units) and oral prednisolone (1 mg/kg per day) significantly improved her hemoptysis with thrombocytopenia. To the best of our knowledge, this is the first case of ITP following Moderna inoculation among Asians. This study highlights a potential adverse effect of mRNA-based COVID-19 vaccines in cancer patients receiving immune checkpoint inhibitors.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2022.03.030