{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:43:36Z","timestamp":1784673816550,"version":"3.55.0"},"reference-count":76,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,12,30]],"date-time":"2022-12-30T00:00:00Z","timestamp":1672358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>This systematic review aimed to retrieve patients diagnosed with de novo immune thrombocytopenic purpura (ITP) after COVID\u201019 immunization to determine their epidemiological characteristics, clinical course, therapeutic strategies, and outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>We conducted the review using four major databases, comprising PubMed, Scopus, Web of Science, and the Cochrane library, until April 2022. A systematic search was performed in duplicate to access eligible articles in English. Furthermore, a manual search was applied to the chosen papers' references to enhance the search sensitivity. Data were extracted and analyzed with the SPSS 20.1 software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 77 patients with de novo COVID\u201019 vaccine\u2010associated ITP were identified from 41 studies, including 31 case reports and 10 case series. The median age of patients who developed COVID\u201019 vaccine\u2010associated ITP was 54\u2009years (IQR 36\u201372\u2009years). The mRNA\u2010based COVID\u201019 vaccines, including BNT16B2b2 and mRNA\u20101273, were most implicated (75.4%). Those were followed by the adenovirus vector\u2010based vaccines, inclusive of ChAdOx1 nCoV\u201019 and vAd26.COV2.S. No report was found relating ITP to other COVID\u201019 vaccines. Most cases (79.2%) developed ITP after the first dose of COVID\u201019 vaccination. 75% of the patients developed ITP within 12\u2009days of vaccination, indicating a shorter lag time compared to ITP after routine childhood vaccinations. Sixty\u2010seven patients (87%) patients were hospitalized. The management pattern was similar to primary ITP, and systemic glucocorticoids, IVIg, or both were the basis of the treatment in most patients. Most patients achieved therapeutic goals; only two individuals required a secondary admission, and one patient who presented with intracranial hemorrhage died of the complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>De novo ITP is a rare complication of COVID\u201019 vaccination, and corresponding reports belong to mRNA\u2010based and adenovirus vector\u2010based vaccines, in order of frequency. This frequency pattern may be related to the scale of administration of individual vaccines and their potency in inducing autoimmunity. The more the COVID\u201019 vaccine is potent to induce antigenic challenge, the shorter the lag time would be. Most patients had a benign course and responded to typical treatments of primary ITP.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.13917","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T08:53:39Z","timestamp":1671785619000},"page":"335-353","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Immune thrombocytopenic purpura secondary to <scp>COVID<\/scp>\u201019 vaccination: A systematic review"],"prefix":"10.1111","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3583-1838","authenticated-orcid":false,"given":"Ali","family":"Bidari","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Rasool Akram Medical Complex Clinical Research Development Center (RCRDC), School of Medicine Iran University of Medical Sciences (IUMS)  Tehran 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