{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T13:18:29Z","timestamp":1771852709825,"version":"3.50.1"},"reference-count":13,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T00:00:00Z","timestamp":1638316800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T00:00:00Z","timestamp":1639180800000},"content-version":"vor","delay-in-days":10,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002839","name":"Charit\u00e9 - Universit\u00e4tsmedizin Berlin","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002839","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>We report a case of a 25-year-old male patient, who developed acquired thrombotic thrombocytopenic purpura (aTTP) after receiving a first dose of mRNA-based SARS-CoV-2 vaccine Spikevax (mRNA-1273, Moderna Biotech, USA). While this is the first case in literature describing a case of aTTP after receiving the Spikevax vaccine, there are two other cases after mRNA-based Covid-19 vaccine and two after adenoviral SARS-CoV-2 vaccine.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>The patient presented with persisting malaise, fever, headache, word-finding difficulties, nausea, vomiting, petechial bleeding, and hematuria 13\u2009days after receiving a first dose of vaccination. Laboratory testing showed low platelet count, Coombs-negative hemolytic anemia, and mild acute kidney injury. We excluded vaccine induced immune thrombotic thrombocytopenia (VITT) as another important differential diagnosis and the final diagnosis was established after ADAMTS-13 (A Disintegrin And Metalloproteinase with a ThromboSpondin type 1 motif, member 13) activity was found to be &lt;\u20091% (reference range\u2009&gt;\u200940%) and ADAMTS-13 antibodies being 72.2\u2009IU\/L (reference range\u2009&lt;\u200912\u2009IU\/L).<\/jats:p>\n                <jats:p>We initiated empiric therapy of plasmapheresis and corticosteroids on admission and started caplacizumab the day after. The patient\u2019s thrombocyte count normalized 3\u2009days after admission, hemolysis and acute kidney injury resolved after 2\u2009weeks. The patient received 2 doses of rituximab (1\u2009g each) after the diagnosis of immune TTP was established. One month after the initial presentation, the patient is in good overall condition, but still receives daily caplacizumab due to ADAMTS-13 activity of &lt;\u20091%.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Low platelet count after vaccination against SARS-CoV-2 has gained attraction after vaccine-induced immune thrombotic thrombocytopenia (VITT) has been described as a rare but severe complication of adenoviral-based vaccines. Thrombotic thrombocytopenic purpura (TTP) is an important differential diagnosis, but there are only few reports of TTP following SARS-CoV-2 vaccination. Despite pathophysiological and clinical differences of both entities, diagnostic uncertainty can result in the acute setting, since they share main symptoms such as headache and neurological alterations in addition to thrombocytopenia. In difference to other cases reported, this patient developed first symptoms of TTP as early as 4 days after vaccination, which suggests that vaccination merely acted as trigger for occult TTP, instead of truly inducing an autoimmunological process.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12882-021-02616-3","type":"journal-article","created":{"date-parts":[[2021,12,11]],"date-time":"2021-12-11T10:02:34Z","timestamp":1639216954000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["First diagnosis of thrombotic thrombocytopenic purpura after SARS-CoV-2 vaccine \u2013 case report"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8660-0722","authenticated-orcid":false,"given":"Bilgin","family":"Osmanodja","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Schreiber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Schrezenmeier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evelyn","family":"Seelow","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,11]]},"reference":[{"issue":"1","key":"2616_CR1","doi-asserted-by":"publisher","first-page":"17020","DOI":"10.1038\/nrdp.2017.20","volume":"3","author":"JA Kremer Hovinga","year":"2017","unstructured":"Kremer Hovinga JA, Coppo P, L\u00e4mmle B, Moake JL, Miyata T, Vanhoorelbeke K. 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First report of a de novo iTTP episode associated with an mRNA-based anti-COVID-19 vaccination. J Thromb Haemost. 2021. https:\/\/doi.org\/10.1111\/jth.15418.","DOI":"10.1111\/jth.15418"},{"key":"2616_CR11","doi-asserted-by":"publisher","unstructured":"Waqar SHB, Khan AA, Memon S. Thrombotic thrombocytopenic purpura: a new menace after COVID bnt162b2 vaccine. Int J Hematol. 2021. https:\/\/doi.org\/10.1007\/s12185-021-03190-y.","DOI":"10.1007\/s12185-021-03190-y"},{"key":"2616_CR12","doi-asserted-by":"publisher","unstructured":"Al-Ahmad M, Al-Rasheed M, Shalaby NAB. Acquired thrombotic thrombocytopenic purpura with possible association with AstraZeneca-Oxford COVID-19 vaccine. EJHaem. 2021. https:\/\/doi.org\/10.1002\/jha2.219.","DOI":"10.1002\/jha2.219"},{"key":"2616_CR13","doi-asserted-by":"publisher","unstructured":"Yocum A, Simon EL. Thrombotic thrombocytopenic Purpura after Ad26.COV2-S vaccination. 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