Acquired immune thrombotic thrombocytopenic purpura(TTP)associated with inactivated COVID-19 vaccine CoronaVac  

作　　者：Zhangbiao Long Suyu Jiang Honglei Xin Lu Zhang Ruinan Lu Fengqi Liu Yong Xu Linv Wang Jun Wang Xuezhong Zhang Hui Liao Jinning Shi Xue Yan Xiang Zhu Ruonan Shao Zijian Li Yilin Zhu Han Yan Jiao Wu Chao Fang Xiaodong Xi Xiaofeng Shi 

机构地区：[1]Department of Hematology,The First Affiliated Hospital of Anhui Medical University,Hefei,230022,China [2]Department of Hematology,The Second Affiliated Hospital of Nanjing Medical University,Nanjing,210003,China [3]Department of Hematology,The First Affiliated Hospital of Nanjing Medical University,Jiangsu Province Hospital,Nanjing,210029,China [4]Department of Hematology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing,210008,China [5]Department of Hematology,The Affiliated Hospital of Nanjing University of Chinese Medicine,The First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing,210009,China [6]Department of Hematology,Zhongda Hospital of Southeast University,Nanjing,210044,China [7]Department of Hematology,Nanjing First Hospital,Nanjing Medical University,Nanjing,210006,China [8]Department of Hematology,The Air Force Hospital of Eastern Theater command,Nanjing,210016,China [9]Department of Hematology,Jiangning Hospital Affiliated of Nanjing Medical University,Nanjing,211199,China [10]Department of Hematology,Nanjing Hospital of Chinese Medicine,Nanjing,210006,China [11]Department of Pharmacology,School of Basic Medicine,Tongji Medical College and State Key Laboratory for Diagnosis and Treatment of Severe Zoonotic Infectious Diseases,Huazhong University of Science and Technology,The Key Laboratory for Drug Target Researches and Pharmacodynamic Evaluation of Hubei Province,Wuhan,430030,China [12]Shanghai Institute of Hematology,State Key Laboratory of Medical Genomics,Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China

出　　处：《Frontiers of Medicine》2024年第4期744-751,共8页医学前沿（英文版）

基　　金：supported by the National Natural Science Foundation of China(Nos.81700130,82370134,92169114,81802932);the Natural Science Fund for Distinguished Young Scholars of Hubei Province(No.2022CFA054);the National Key Research and Development Program of China(No.2018YFE0113600).

摘　　要：Corona virus disease 2019(COVID-19)due to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has affected the whole world.Acquired thrombotic thrombocytopenic purpura(TTP)has been reported after administration of mRNA-or adenoviral vector-based COVID-19 vaccines,including Ad26.COV2-S,BNT162b2,mRNA-1273,and ChAdOx1 nCov-19.However,whether inactivated vaccines,such as CoronaVac,could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown.In this study,two cases were reported.Both cases developed TTP after the second CoronaVac vaccination shot,but not the first.They demonstrated symptoms of fever,neurological abnormalities,renal dysfunction,thrombocytopenia,and hemolysis.Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression.The incidence of TTP in Nanjing area was analyzed.The number of patients with TTP was 12 in 2019,6 in 2020,16 in 2021,and 19 in 2022.To the authors’knowledge,this report is the first report of TTP associated with inactivated COVID-19 vaccine(CoronaVac).The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones.Timely plasma exchange is a vital treatment for CoronaVac-related TTP,similar to activated vaccine-related TTP.

关 键 词：thrombotic thrombocytopenia purpura(TTP) corona virus disease 2019(COVID-19) CoronaVac acute respiratory syndrome coronavirus 2(SARS-CoV-2) VACCINE 

分 类 号：R186[医药卫生—流行病学] R558.2[医药卫生—公共卫生与预防医学]