{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T08:34:25Z","timestamp":1758702865643,"version":"3.41.2"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec><jats:title>Key Clinical Message<\/jats:title><jats:p>Vincristine therapy can be effective in refractory Immune thrombocytopenia (ITP) following COVID\u201019 vaccination. Our case report highlights the need for further research to establish standard management guidelines for COVID\u201019\u2010vaccine\u2010associated ITP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>Adult immune thrombocytopenia (ITP) can occur as a rare complication following several viral infections or a rare adverse event or complication of vaccination. In this paper, we report a case of a 39\u2010year\u2010old male patient with severe refractory ITP that began 4\u2010weeks after receiving his third (booster) dose of the COVID\u201019 vaccine (BNT162b2, Pfizer\u2010BioNTech). He was given oral dexamethasone 40\u2009mg daily for 4\u2009days followed by prednisone at 1\u2009mg\/kg (85\u2009mg daily) for 10\u2009days. In the following weeks, we attempted several other lines of therapy to treat his ITP, including anti\u2010RhD immunoglobulin, which, unfortunately, caused moderate hemolysis requiring packed red blood cell transfusion, intravenous immunoglobulin (given at a subtherapeutic dose of 0.4\u2009g\/kg for only 1\u2009day since it was not available), rituximab, and eltrombopag. The patient, unfortunately, showed no response to any of these treatments. This was an indicator to initiate salvage therapy with vincristine 2\u2009mg weekly for 3\u2009weeks. The patient's platelet count started to increase remarkably during the third week of vincristine and normalized after 4\u2009weeks. We review the findings, clinical characteristics, and management approaches that were reported in the literature regarding COVID\u201019\u2010vaccine\u2010induced ITP. More in\u2010depth research is needed to delineate standard guidelines for the management of such cases. This report underscores the importance of resorting to vincristine and eltrombopag as great options for severe and refractory ITP related to the COVID\u201019 vaccine.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccr3.9070","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T07:45:57Z","timestamp":1718351157000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["<scp>COVID<\/scp>\u201019\u2010induced immune thrombocytopenia management approach: A case report and literature review"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3961-0765","authenticated-orcid":false,"given":"Hatem Mahmoud","family":"Alahwal","sequence":"first","affiliation":[{"name":"Hematology Department, Faculty of Medicine King Abdulaziz University  Jeddah Saudi Arabia"},{"name":"Hematology Research Unit, King Fahd Medical Research Center King Abdulaziz University  Jeddah Saudi 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