{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T14:33:50Z","timestamp":1771684430137,"version":"3.50.1"},"reference-count":8,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,6,8]]},"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:p>Immune thrombocytopenic purpura (ITP) is an autoimmune disorder caused by autoantibodies against platelet antigens resulting in platelet destruction and inhibition of platelet production. Occasionally, an inciting event such as a virus or vaccination can precipitate ITP. Several cases of ITP have been reported after the BTN162b2 (Pfizer-BioNTech) and mRNA-1273 (Moderna) SARS-CoV-2 (COVID-19) vaccines. All reported cases of post-vaccination ITP have resolved with medical therapy until this case.<\/jats:p>\n               <jats:p>A man in his mid-20s developed bleeding from ITP 2 weeks after receiving the second dose of the Pfizer SARS-CoV-2 vaccine. All inpatient medical treatment attempts failed. On hospital day 40, a splenectomy was performed and he ultimately recovered and was discharged.<\/jats:p>\n               <jats:p>Awareness of potential vaccination side effects is a fundamental element of refining and improving patient safety. This case illustrates that given the right circumstances, serious refractory ITP can develop in response to the second dose of the Pfizer SARS-CoV-2 vaccine.<\/jats:p>","DOI":"10.1136\/bcr-2022-250153","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T12:52:45Z","timestamp":1655729565000},"page":"e250153","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Severe case of refractory immune thrombocytopenic purpura requiring splenectomy after the COVID-19 vaccine"],"prefix":"10.1136","volume":"15","author":[{"given":"Sarina","family":"Koilpillai","sequence":"first","affiliation":[{"name":"Internal Medicine, Orlando Regional Healthcare, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Dominguez","sequence":"additional","affiliation":[{"name":"Internal Medicine, Orlando Regional Healthcare, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azeem","family":"Khan","sequence":"additional","affiliation":[{"name":"Pathology, Orlando Regional Healthcare, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9867-8538","authenticated-orcid":false,"given":"Steve","family":"Carlan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Orlando Health Corp, Orlando, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"2025082712414407000_15.6.e250153.1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.tcm.2021.08.012","article-title":"The roles of platelets in COVID-19-associated coagulopathy and vaccine-induced immune thrombotic thrombocytopenia","volume":"32","author":"Iba","year":"2022","journal-title":"Trends Cardiovasc Med"},{"key":"2025082712414407000_15.6.e250153.2","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1182\/blood.2019003599","article-title":"Identifying and treating refractory ITP: difficulty in diagnosis and role of combination treatment","volume":"135","author":"Miltiadous","year":"2020","journal-title":"Blood"},{"key":"2025082712414407000_15.6.e250153.3","doi-asserted-by":"crossref","first-page":"102615","DOI":"10.1016\/j.bcmd.2021.102615","article-title":"Severe immune thrombocytopenia after COVID-19 vaccination: report of four cases and review of the literature","volume":"92","author":"Gardellini","year":"2021","journal-title":"Blood Cells Mol Dis"},{"key":"2025082712414407000_15.6.e250153.4","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/MBC.0000000000001082","article-title":"ChAdOx1 nCoV-19 vaccine-associated thrombocytopenia: three cases of immune thrombocytopenia after 107\u200a720 doses of ChAdOx1 vaccination in Thailand","volume":"33","author":"Uaprasert","year":"2022","journal-title":"Blood Coagul Fibrinolysis"},{"key":"2025082712414407000_15.6.e250153.5","first-page":"273","article-title":"Idiopathic thrombocytopenic purpura (ITP) - new era for an old disease","volume":"57","author":"Onis\u00e2i","year":"2019","journal-title":"Rom J Intern Med"},{"key":"2025082712414407000_15.6.e250153.6","article-title":"Treatments for primary immune thrombocytopenia: a review","volume":"11","author":"Samson","year":"2019","journal-title":"Cureus"},{"key":"2025082712414407000_15.6.e250153.7","doi-asserted-by":"crossref","DOI":"10.3390\/medicina56120667","article-title":"Immune thrombocytopenia (ITP): current limitations in patient management","volume":"56","author":"Terrell","year":"2020","journal-title":"Medicina"},{"key":"2025082712414407000_15.6.e250153.8","doi-asserted-by":"crossref","first-page":"221","DOI":"10.2147\/JBM.S307047","article-title":"Severe, refractory immune thrombocytopenia occurring after SARS-CoV-2 vaccine","volume":"12","author":"Helms","year":"2021","journal-title":"J Blood Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-250153","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T19:41:55Z","timestamp":1756323715000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-250153"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6]]},"references-count":8,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2022,6,20]]},"published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1136\/bcr-2022-250153"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-250153","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6]]}}}