The COVID-19 pandemic has prompted the rapid development and administration of various vaccines worldwide, with some reports linking these vaccines to immune thrombotic thrombocytopenic purpura (TTP). This report presents two cases of TTP occurring after the administration of the inactivated vaccine CoronaVac from Sinovac Biotech, highlighting the potential association between this type of vaccine and TTP. The article also provides an analysis of TTP incidence in the Nanjing area of China, suggesting a possible correlation between COVID-19 vaccination and the occurrence of TTP.
The first case details a 23-year-old female who developed symptoms of TTP three days after receiving her second dose of CoronaVac. Initially presenting with dizziness and weakness, her condition progressed to include thrombocytopenia, anemia, elevated lactate dehydrogenase (LDH), and α-hydroxybutyrate dehydrogenase (α-HBDH) levels, with further deterioration indicated by decreased platelet count, hemoglobin levels, and the presence of schistocytes in peripheral blood smears. Despite negative SARS-CoV-2 PCR test results, the patient was treated with dexamethasone, intravenous immunoglobulin, and platelet transfusion.
Her condition improved following the introduction of glucocorticoids, plasma exchange, and rituximab, with a gradual return to normal values for ADAMTS13 antigen and inhibitory antibodies. The second case involves a 45-year-old female who experienced fever and muscle soreness five days af.