{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T01:27:41Z","timestamp":1789694861643,"version":"4.0.1"},"reference-count":9,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,4,13]]},"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:p>Epistaxis may be attributed to many causes during the winter including dry mucous membranes from low indoor humidity from heating. However, epistaxis may also be due to thrombocytopaenia. Immune thrombocytopaenia purpura (ITP) is an autoimmune disorder causing thrombocytopaenia. Viral infections sometimes lead to ITP. Vaccines, predominantly the measles-mumps-rubella vaccine, have been associated with the development of ITP. There are several published case reports regarding influenza vaccine induced ITP. However, an association between ITP and influenza vaccination has not been firmly proven yet. We report the case of an adult with three episodes of epistaxis, each within 1\u2009week of receiving a yearly influenza trivalent inactivated vaccine, the last episode being more severe and also featuring gross haematuria.<\/jats:p>","DOI":"10.1136\/bcr-2019-229423","type":"journal-article","created":{"date-parts":[[2019,5,7]],"date-time":"2019-05-07T12:23:49Z","timestamp":1557231829000},"page":"e229423","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Epistaxis and gross haematuria with severe thrombocytopaenia associated with influenza vaccination"],"prefix":"10.1136","volume":"12","author":[{"given":"Abdullah","family":"Almohammadi","sequence":"first","affiliation":[{"name":"Hematology and Oncology, Michigan State University, Lansing, Michigan, USA"},{"name":"Internal Medicine, Sparrow Hospital, Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8078-8795","authenticated-orcid":false,"given":"Michael S","family":"Lundin","sequence":"additional","affiliation":[{"name":"Internal Medicine, Sparrow Hospital, Lansing, Michigan, USA"},{"name":"Internal Medicine, Michigan State University, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Calvin","family":"Abro","sequence":"additional","affiliation":[{"name":"Internal Medicine, Sparrow Hospital, Lansing, Michigan, USA"},{"name":"Internal Medicine, Michigan State University, East Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Borys","family":"Hrinczenko","sequence":"additional","affiliation":[{"name":"Hematology and Oncology, Michigan State University, Lansing, Michigan, USA"},{"name":"Internal Medicine, Sparrow Hospital, Lansing, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,5,6]]},"reference":[{"key":"2025082700343362000_12.5.e229423.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.279206"},{"key":"2025082700343362000_12.5.e229423.2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1111\/j.1600-0609.2008.01208.x","article-title":"Immune thrombocytopenic purpura: the treatment paradigm","volume":"71","author":"Stasi","year":"2009","journal-title":"Eur J Haematol Suppl"},{"key":"2025082700343362000_12.5.e229423.3","doi-asserted-by":"publisher","DOI":"10.1177\/0961203313499959"},{"key":"2025082700343362000_12.5.e229423.4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-05-431098"},{"key":"2025082700343362000_12.5.e229423.5","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-200302000-00006"},{"key":"2025082700343362000_12.5.e229423.6","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1981.03310290037020"},{"key":"2025082700343362000_12.5.e229423.7","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-0124","article-title":"Recurrent Immune Thrombocytopenia After Influenza Vaccination: A Case Report","volume":"138","author":"Hamiel","year":"2016","journal-title":"Pediatrics"},{"key":"2025082700343362000_12.5.e229423.8","first-page":"630","article-title":"Immune thrombocytopenia; following seasonal flu vaccine and non-steroidal anti-inflammatory drug use","volume":"23","author":"Aktas","year":"2016","journal-title":"Professional Med J"},{"key":"2025082700343362000_12.5.e229423.9","first-page":"1","article-title":"Postinfluenza Vaccination Idiopathic Thrombocytopenic Purpura in Three Elderly Patients","volume":"2016","author":"Nagasaki","year":"2016","journal-title":"Case Rep Hematol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-229423","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:34:46Z","timestamp":1756280086000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-229423"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5]]},"references-count":9,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5,6]]},"published-print":{"date-parts":[[2019,5]]}},"alternative-id":["10.1136\/bcr-2019-229423"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-229423","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,5]]}}}