{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T15:51:58Z","timestamp":1762876318650,"version":"3.44.0"},"reference-count":10,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,9,25]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:p>A 50-year-old Indian woman presented with acute dysphasia, left upper limb numbness and thrombocytopenia 12 days after receiving the ChAdOx1 nCoV-19 vaccine (AstraZeneca\/Vaxzevria). MRI of the brain was unremarkable. Microangiopathic haemolytic anaemia with thrombocytopenia was noted on her peripheral blood film. A diagnosis of thrombotic thrombocytopenic purpura (TTP) was confirmed through the findings of absent ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) activity and markedly raised titre of ADAMTS13 autoantibodies. Prompt treatment with plasma exchange, adjunctive steroids and rituximab was commenced. A remission of TTP was achieved and she was discharged 3\u2009weeks after admission. While other immune-mediated conditions have been documented after receipt of the vaccine, this report highlights the first case of immune-mediated TTP diagnosed after administration of the ChAdOx1 nCoV-19 vaccine.<\/jats:p>","DOI":"10.1136\/bcr-2021-246049","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T11:58:45Z","timestamp":1633694325000},"page":"e246049","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":19,"title":["Thrombotic thrombocytopenic purpura after ChAdOx1 nCoV-19 vaccine"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0713-7021","authenticated-orcid":false,"given":"Hui Ping","family":"Lee","sequence":"first","affiliation":[{"name":"College of Medical and Dental Sciences, University of Birmingham, Birmingham, West Midlands, UK"},{"name":"Medicine, Queen Elizabeth Hospital Birmingham, Birmingham, West Midlands, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veena","family":"Selvaratnam","sequence":"additional","affiliation":[{"name":"Haematology, Hospital Ampang, Ampang, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay Suriar","family":"Rajasuriar","sequence":"additional","affiliation":[{"name":"Haematology, Gleneagles Hospital Kuala Lumpur, Kuala Lumpur, Wilayah Persekutuan, Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,10,8]]},"reference":[{"key":"2025082707092838000_14.10.e246049.1","unstructured":"European Medicines Agency . 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