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Acquired Thrombotic Thrombocytopenic Purpura: A Rare Coincidence after COVID-19 mRNA Vaccine?

journal contribution
posted on 09.07.2022, 01:39 authored by Tso ACY, Ong KH, Sum CLL, Fan BE, Chan GYL, Christopher D, Howe HS, Lai YW, Lim XR, Pui Lam Bernard LeungPui Lam Bernard Leung

We present 3 patients who developed acquired thrombotic thrombocytopenic purpura (aTTP) after receiving BNT162b2 mRNA COVID-19 vaccines. The clinical diagnoses were confirmed by the significantly reduced ADAMTS13 activities (<0.1 IU/mL) and markedly elevated auto-antibodies to ADAMTS13. We attempted to establish a causal link between the mRNA vaccine and the effectuation of aTTP. Using the ELISA methodology incubating the patients’ plasma and/or serum samples with two different commercial biotinylated recombinant COVID Spike S1 proteins, no binding to both ADAMTS13 and Covid Spike S1 protein was seen.  Although based on these assays, no cross reactivity was demonstrated between the patients’ autoantibodies to ADAMTS13 and the anti-S1 Spike protein antibody, we cannot exclude other mechanisms which may enhance autoimmunity leading to the development of aTTP.

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Nil

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Journal/Conference/Book title

Seminars in Thrombosis and Hemostasis

Publication date

2022-06-27

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Published

Rights statement

This is the publisher's PDF version of: Tso, A. C. Y., K. H. Ong, C. L. L. Sum, B. E. Fan, G. Y. L. Chan, D. Christopher, H. S. Howe, Y. W. Lai, X. R. Lim, and B. P. L. Leung. 2022. Acquired Thrombotic Thrombocytopenic Purpura: A Rare Coincidence after COVID-19 mRNA Vaccine? Semin Thromb Hemost. https://doi.org/10.1055/s-0042-1744301.

Corresponding author

Allison C. Y. Tso/allison_cy_tso@ttsh.com.sg

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