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We report the clinical characteristics of two patients with <jats:styled-content style=\"fixed-case\">KHE<\/jats:styled-content> involving the right upper arm. The patients demonstrated rapid enlargement of the lesion with severe <jats:styled-content style=\"fixed-case\">KMP<\/jats:styled-content> shortly after vaccination. Sirolimus was used to treat the <jats:styled-content style=\"fixed-case\">KHE<\/jats:styled-content> with <jats:styled-content style=\"fixed-case\">KMP<\/jats:styled-content>. The patients showed a quick normalization of the platelet level. The follow\u2010up examination revealed that the size of the mass was significantly decreased. This report raises the intriguing possibility that extrinsic factors may contribute to the development of <jats:styled-content style=\"fixed-case\">KMP<\/jats:styled-content> in the context of an already existing <jats:styled-content style=\"fixed-case\">KHE<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/1346-8138.14598","type":"journal-article","created":{"date-parts":[[2018,8,17]],"date-time":"2018-08-17T15:43:37Z","timestamp":1534520617000},"page":"1203-1206","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Development of Kasabach\u2013Merritt phenomenon following vaccination: More than a coincidence?"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9289-9660","authenticated-orcid":false,"given":"Yi","family":"Ji","sequence":"first","affiliation":[{"name":"Division of Oncology Department of Pediatric Surgery West China Hospital of Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit Department of Critical Care Medicine West China Hospital of Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaiying","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Oncology Department of Pediatric Surgery West China Hospital of Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunchao","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Radiology West China Hospital of Sichuan University Chengdu China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhua","family":"Peng","sequence":"additional","affiliation":[{"name":"Division of Oncology Department of Pediatric Surgery West China Hospital of Sichuan University Chengdu 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