Characteristics of cases of relapses of immune thrombocytopenia following COVID-19 vaccination
| Characteristics . | All cases (n = 17) . | BNT162b2 (Pfizer-BioNTech, n = 12) . | ChadOx1-S (AstraZeneca, n = 2) . | mRNA-1273 (Moderna, n = 3) . |
|---|---|---|---|---|
| Median age, y (minimum-maximum) | 61 (22-87) | 65 (22-87) | 44 (25-63) | 56 (50-62) |
| Women, n (%) | 11 (64.7) | 7 (63.6) | 2 (100) | 2 (66.3) |
| History of other autoimmune disease, n (%) | 3 (17.6)* | 3 (25.0) | 0 | 0 |
| Splenectomized, n (%) | 2 (11.8) | 1 (8.3) | 1 (50.0) | 0 |
| Dose | ||||
| 1, n (%) | 12 (70.6) | 7 (58.3) | 2 (100) | 3 (100.0) |
| 2, n (%) | 5 (29.4) | 5 (41.7) | 0 | 0 |
| Median time to ITP onset, d (minimum-maximum)† | 5 (1-32) | 6 (1-27) | 12 (2-40) | 2 (2-19) |
| Median lowest platelet count, ×109/L (minimum-maximum) | 6 (0-61) | 8 (1-31) | 33 (5-61) | 13 (0-21) |
| Bleeding† | ||||
| No bleeding, n (%) | 1 (5.9) | 1 (8.3) | 0 | 0 |
| All bleeding, n (%) | 15 (88.3) | 10 (83.3) | 2 (100) | 3 (100) |
| Mouth bullae, n (%) | 1 (5.9) | 1 (8.3) | 0 | 0 |
| Epistaxis, n (%) | 0 | 0 | 0 | 0 |
| Hemoptysis, n (%) | 0 | 0 | 0 | 0 |
| Intracranial, n (%) | 0 | 0 | 0 | 0 |
| Evolution and treatment‡ | ||||
| Spontaneous recovery, n (%) | 3 (27.3) | 2 (22.2) | 1 (100) | 0 |
| Recovery after corticosteroids ± IVIG only, n (%) | 6 (54.5) | 6 (66.7) | 0 | 0 |
| Recovery after reintroduction of TPORA, n (%) | 1 (9.1) | 0 | 0 | 1 (100) |
| Recovery after need of vinblastine for refractory disease to corticosteroids, IVIG and TPORA, n (%) | 1 (9.1) | 1 (11.1) | 0 | 0 |
| Exposure to another dose of vaccine | ||||
| Relapse of ITP, n | 1 | 0 | 0 | 1 |
| No relapse of ITP, n | 2 | 2 | 0 | 0 |
| Absence of subsequent exposure to the vaccine, n | 6 | 6 | 0 | 0 |
| Unknown, n | 8 | 4 | 5 | 2 |
| Characteristics . | All cases (n = 17) . | BNT162b2 (Pfizer-BioNTech, n = 12) . | ChadOx1-S (AstraZeneca, n = 2) . | mRNA-1273 (Moderna, n = 3) . |
|---|---|---|---|---|
| Median age, y (minimum-maximum) | 61 (22-87) | 65 (22-87) | 44 (25-63) | 56 (50-62) |
| Women, n (%) | 11 (64.7) | 7 (63.6) | 2 (100) | 2 (66.3) |
| History of other autoimmune disease, n (%) | 3 (17.6)* | 3 (25.0) | 0 | 0 |
| Splenectomized, n (%) | 2 (11.8) | 1 (8.3) | 1 (50.0) | 0 |
| Dose | ||||
| 1, n (%) | 12 (70.6) | 7 (58.3) | 2 (100) | 3 (100.0) |
| 2, n (%) | 5 (29.4) | 5 (41.7) | 0 | 0 |
| Median time to ITP onset, d (minimum-maximum)† | 5 (1-32) | 6 (1-27) | 12 (2-40) | 2 (2-19) |
| Median lowest platelet count, ×109/L (minimum-maximum) | 6 (0-61) | 8 (1-31) | 33 (5-61) | 13 (0-21) |
| Bleeding† | ||||
| No bleeding, n (%) | 1 (5.9) | 1 (8.3) | 0 | 0 |
| All bleeding, n (%) | 15 (88.3) | 10 (83.3) | 2 (100) | 3 (100) |
| Mouth bullae, n (%) | 1 (5.9) | 1 (8.3) | 0 | 0 |
| Epistaxis, n (%) | 0 | 0 | 0 | 0 |
| Hemoptysis, n (%) | 0 | 0 | 0 | 0 |
| Intracranial, n (%) | 0 | 0 | 0 | 0 |
| Evolution and treatment‡ | ||||
| Spontaneous recovery, n (%) | 3 (27.3) | 2 (22.2) | 1 (100) | 0 |
| Recovery after corticosteroids ± IVIG only, n (%) | 6 (54.5) | 6 (66.7) | 0 | 0 |
| Recovery after reintroduction of TPORA, n (%) | 1 (9.1) | 0 | 0 | 1 (100) |
| Recovery after need of vinblastine for refractory disease to corticosteroids, IVIG and TPORA, n (%) | 1 (9.1) | 1 (11.1) | 0 | 0 |
| Exposure to another dose of vaccine | ||||
| Relapse of ITP, n | 1 | 0 | 0 | 1 |
| No relapse of ITP, n | 2 | 2 | 0 | 0 |
| Absence of subsequent exposure to the vaccine, n | 6 | 6 | 0 | 0 |
| Unknown, n | 8 | 4 | 5 | 2 |
Abbreviations: ITP, immune thrombocytopenia; IVIG, intravenous immunoglobulin; TPORA, thrombopoietin receptor agonist.
2 patients with Graves' disease and 1 with autoimmune hemolytic anemia (Evans' syndrome).
1 missing value (with BNT162b).
6 missing values (3 with BNT162b, 2 with ChadOx1-S, and 1 with mRNA-1273).