Vaccine-induced immune thrombocytopaenia purpura in autologous haematopoietic stem cell transplantation

Med J Malaysia. 2018 Dec;73(6):430-432.

Abstract

Immune Thrombocytopenia Purpura (ITP) secondary to vaccinations is rare, especially after autologous hematopoietic stem cell transplantation (HSCT). A 31-yearold female received autologous HSCT for relapsed Hodgkin Disease, with platelet engraftment at Day+14. One week after receiving second scheduled vaccinations, she developed severe thrombocytopenia (3x109/L) associated with pharyngeal hematoma. Bone marrow (BM) examinations were consistent with ITP, possibly secondary to Influenza vaccine. Platelet increment was poor despite high dose corticosteroids, intravenous immunoglobulin (IVIG), Danazol and Eltrombopag. A repeated BM biopsy was in agreement with ITP. Re-treatment with tapering doses of prednisolone resulted in stable platelet counts at 120x109/L a year later.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diphtheria-Tetanus-Pertussis Vaccine / adverse effects
  • Female
  • Haemophilus Vaccines / adverse effects
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Hepatitis B Vaccines / adverse effects
  • Hodgkin Disease / surgery
  • Humans
  • Influenza Vaccines / adverse effects
  • Pneumococcal Vaccines / adverse effects
  • Purpura, Thrombocytopenic, Idiopathic / etiology*
  • Transplantation, Autologous / adverse effects
  • Vaccines / adverse effects*

Substances

  • Diphtheria-Tetanus-Pertussis Vaccine
  • Haemophilus Vaccines
  • Hepatitis B Vaccines
  • Influenza Vaccines
  • Pneumococcal Vaccines
  • Vaccines