Successful Treatment of Immune Thrombocytopenic Purpura with Intracranial Hemorrhaging and Duodenal Bleeding Following SARS-CoV-2 Vaccination

Intern Med. 2022 Jun 15;61(12):1891-1895. doi: 10.2169/internalmedicine.9199-21. Epub 2022 Apr 9.

Abstract

Several vaccines have been developed for coronavirus disease 2019 - caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - in record time. A few cases of immune thrombocytopenic purpura (ITP) following SARS-CoV-2 vaccination have been reported. We herein report a 90-year-old man who received the Pfizer-BioNTech SARS-CoV-2 vaccine (BNT162b2) and developed severe thrombocytopenia with intracranial hemorrhaging and duodenal bleeding, consistent with vaccine-related ITP. He was successfully treated with intravenous immunoglobulin, prednisolone, and eltrombopag and discharged without cytopenia. Vaccine-related ITP should be suspected in patients presenting with abnormal bleeding or purpura after vaccination.

Keywords: SARS-CoV-2 vaccine; bleeding; immune thrombocytopenic purpura.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • BNT162 Vaccine* / adverse effects
  • COVID-19*
  • Humans
  • Intracranial Hemorrhages* / chemically induced
  • Intracranial Hemorrhages* / drug therapy
  • Male
  • Purpura, Thrombocytopenic, Idiopathic* / chemically induced
  • Purpura, Thrombocytopenic, Idiopathic* / drug therapy
  • Thrombocytopenia* / chemically induced
  • Thrombocytopenia* / drug therapy
  • Vaccination / adverse effects

Substances

  • BNT162 Vaccine