{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T23:41:36Z","timestamp":1794440496167,"version":"4.9.1"},"reference-count":29,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,7,5]]},"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:p>Thrombotic thrombocytopenic purpura (TTP) is a life-threatening disease that may be triggered by inflammation, including infection or vaccination. Since the start of the COVID-19 pandemic, several case reports were published on de novo or relapsed immune TTP (iTTP) in COVID-19-infected patients. Case reports of iTTP episodes following vaccination against COVID-19 are also emerging. We report a case of relapsed iTTP in a patient who received Moderna mRNA-1273 SARS-CoV-2 vaccine and developed concurrent severe COVID-19 infection. The patient\u2019s iTTP was successfully managed with caplacizumab, therapeutic plasma exchange and high-dose steroids. We summarise published cases of iTTP associated with COVID-19 infection or vaccination.<\/jats:p>","DOI":"10.1136\/bcr-2021-247524","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T12:38:36Z","timestamp":1659011916000},"page":"e247524","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Relapse of immune thrombotic thrombocytopenic purpura (iTTP) possibly triggered by COVID-19 vaccination and\/or concurrent COVID-19 infection"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6700-5197","authenticated-orcid":false,"given":"Fei","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1994-8662","authenticated-orcid":false,"given":"Brandon","family":"Tse","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Pavenski","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Laboratory Medicine & Pathobiology, University of Toronto, Toronto, Ontario, Canada"},{"name":"Departments of Laboratory Medicine and Medicine, St Michael's Hospital, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"2025082722585442000_15.7.e247524.1","doi-asserted-by":"crossref","first-page":"536","DOI":"10.3390\/jcm10030536","article-title":"Thrombotic thrombocytopenic purpura: pathophysiology, diagnosis, and management","volume":"10","author":"Sukumar","year":"2021","journal-title":"J Clin Med"},{"key":"2025082722585442000_15.7.e247524.2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15191"},{"key":"2025082722585442000_15.7.e247524.3","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1055\/s-0041-1723784","article-title":"Low ADAMTS13 activity correlates with increased mortality in COVID-19 patients","volume":"5","author":"Sweeney","year":"2021","journal-title":"TH Open"},{"key":"2025082722585442000_15.7.e247524.4","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.thromres.2020.05.032","article-title":"Adamts13 activity, von Willebrand factor, factor VIII and D-dimers in COVID-19 inpatients","volume":"192","author":"Escher","year":"2020","journal-title":"Thromb Res"},{"key":"2025082722585442000_15.7.e247524.5","unstructured":"AL-Ansari R , Bakkar M , Abdalla L . 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