{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T10:15:38Z","timestamp":1753438538685,"version":"3.37.3"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T00:00:00Z","timestamp":1670889600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T00:00:00Z","timestamp":1670889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81800681","81873595)"],"award-info":[{"award-number":["81800681","81873595)"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Municipal Key Clinical Specialty","award":["shslczdzk02503"],"award-info":[{"award-number":["shslczdzk02503"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Thrombotic thrombocytopenic purpura (TTP) is a rare and life-threatening thrombotic microangiopathy characterized by microangiopathic hemolytic anemia, severe thrombocytopenia, and organ ischemia. It is related to severe deficiency in ADAMTS13, which is usually acquired via ADAMTS13 autoantibodies or inherited via mutations of the <jats:italic>ADAMTS13<\/jats:italic> gene. The etiology of acquired TTP including HIV infection, pregnancy, autoimmune disease, organ transplantation, drugs, malignancy and so on. Here, we firstly reported a patient diagnosed as acquired TTP after pegylated interferon therapy for hepatitis B and COVID-19 vaccination.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 36-year-old male attended to our unit with a five-day history of intermittent hematuria and progressive fatigue on January 5th, 2022. He had a 13\u00a0years history of hepatitis B infection and undergone pegylated interferon treatment (which was paused for two months because of COVID-19 vaccination) for nearly 3\u00a0years. Laboratory evaluation revealed a haemoglobin level of 61\u00a0g\/L, platelet count of 11\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L, lactate dehydrogenase 2133 U\/L. The direct and indirect Coombs test were both negative. On a peripheral blood smear, there were about 18.8% schistocytes. Meanwhile, the results of ADAMTS 13 activity and antibody were\u2009&lt;\u20095% and 181.34\u00a0ng\/ml (131.25\u2013646.5), respectively<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>This case firstly reported the rare complication of TTP after pegylated interferon treatment for hepatitis B and COVID-19 vaccine injection. This unique sign warrants more attention as an early cue of diagnosis of TTP and be aware of the rarity adverse effect of interferon therapy and COVID-19 vaccination.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12882-022-03034-9","type":"journal-article","created":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T11:03:57Z","timestamp":1670929437000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Thrombotic thrombocytopenic purpura developed after pegylated interferon treatment for hepatitis B infection"],"prefix":"10.1186","volume":"23","author":[{"given":"Shuqin","family":"Mei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linlin","family":"Cui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiguo","family":"Mao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuezhi","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changlin","family":"Mei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yixin","family":"Qian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,12,13]]},"reference":[{"issue":"5","key":"3034_CR1","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1007\/s12325-015-0212-6","volume":"32","author":"AF Ben-Amor","year":"2015","unstructured":"Ben-Amor AF, Trochanov A, Fischer TZ. Cumulative review of thrombotic microangiopathy, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome reports with subcutaneous interferon beta-1a. Adv Ther. 2015;32(5):445\u201354.","journal-title":"Adv Ther"},{"issue":"2","key":"3034_CR2","doi-asserted-by":"publisher","first-page":"155","DOI":"10.4274\/tjh.galenos.2021.2021.0057","volume":"38","author":"TH Mir","year":"2021","unstructured":"Mir TH. Immune thrombotic thrombocytopenic purpura in a patient with suspected COVID-19: hydroxychloroquine culprit or just happenstance? Turk J Haematol. 2021;38(2):155\u20137.","journal-title":"Turk J Haematol"},{"issue":"1","key":"3034_CR3","first-page":"80","volume":"12","author":"CF Plesa","year":"2022","unstructured":"Plesa CF, Chitimus DM, Sirbu CA, Tantu MM, Ghinescu MC, Anghel D, Ionita-Radu F. Thrombotic thrombocytopenic purpura in interferon beta-1a-treated patient diagnosed with relapsing-remitting multiple sclerosis: a case report. Life (Basel). 2022;12(1):80.","journal-title":"Life (Basel)"},{"issue":"24","key":"3034_CR4","doi-asserted-by":"publisher","first-page":"2824","DOI":"10.1182\/blood-2016-05-715987","volume":"128","author":"D Kavanagh","year":"2016","unstructured":"Kavanagh D, McGlasson S, Jury A, Williams J, Scolding N, Bellamy C, Gunther C, Ritchie D, Gale DP, Kanwar YS, et al. Type I interferon causes thrombotic microangiopathy by a dose-dependent toxic effect on the microvasculature. Blood. 2016;128(24):2824\u201333.","journal-title":"Blood"},{"key":"3034_CR5","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1016\/j.thromres.2018.01.039","volume":"163","author":"H Jia","year":"2018","unstructured":"Jia H, Thelwell C, Dilger P, Bird C, Daniels S, Wadhwa M. Endothelial cell functions impaired by interferon in vitro: Insights into the molecular mechanism of thrombotic microangiopathy associated with interferon therapy. Thromb Res. 2018;163:105\u201316.","journal-title":"Thromb Res"},{"issue":"10","key":"3034_CR6","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2020.262345","volume":"105","author":"M Capecchi","year":"2020","unstructured":"Capecchi M, Mocellin C, Abbruzzese C, Mancini I, Prati D, Peyvandi F. Dramatic presentation of acquired thombotic thrombocytopenic purpura associated with COVID-19. Haematologica. 2020;105(10): e540.","journal-title":"Haematologica"},{"issue":"3","key":"3034_CR7","doi-asserted-by":"publisher","first-page":"e335","DOI":"10.1055\/s-0041-1732342","volume":"5","author":"K Pavenski","year":"2021","unstructured":"Pavenski K. Relapse of immune thrombotic thrombocytopenic purpura following vaccination with COVID19 mRNA Vaccine. TH Open. 2021;5(3):e335\u20137.","journal-title":"TH Open"},{"issue":"6","key":"3034_CR8","doi-asserted-by":"publisher","first-page":"1585","DOI":"10.1111\/jth.15341","volume":"19","author":"I Nazy","year":"2021","unstructured":"Nazy I, Sachs UJ, Arnold DM, McKenzie SE, Choi P, Althaus K, Ahlen MT, Sharma R, Grace RF, Bakchoul T. Recommendations for the clinical and laboratory diagnosis of VITT against COVID-19: communication from the ISTH SSC subcommittee on platelet immunology. J Thromb Haemost. 2021;19(6):1585\u20138.","journal-title":"J Thromb Haemost"},{"issue":"10","key":"3034_CR9","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1002\/ajh.23525","volume":"88","author":"L Tang","year":"2013","unstructured":"Tang L, Jian XR, Hamasaki N, Guo T, Wang HF, Lu X, Wang QY, Hu Y. Molecular basis of protein S deficiency in China. Am J Hematol. 2013;88(10):899\u2013905.","journal-title":"Am J Hematol"},{"issue":"1","key":"3034_CR10","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s13023-019-1070-0","volume":"14","author":"HS Choi","year":"2019","unstructured":"Choi HS, Choi Q, Kim JA, Im KO, Park SN, Park Y, Shin HY, Kang HJ, Kook H, Kim SY, et al. Molecular diagnosis of hereditary spherocytosis by multi-gene target sequencing in Korea: matching with osmotic fragility test and presence of spherocyte. Orphanet J Rare Dis. 2019;14(1):114.","journal-title":"Orphanet J Rare Dis"}],"container-title":["BMC Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-022-03034-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12882-022-03034-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12882-022-03034-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,13]],"date-time":"2022-12-13T11:07:28Z","timestamp":1670929648000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcnephrol.biomedcentral.com\/articles\/10.1186\/s12882-022-03034-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,13]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["3034"],"URL":"https:\/\/doi.org\/10.1186\/s12882-022-03034-9","relation":{},"ISSN":["1471-2369"],"issn-type":[{"type":"electronic","value":"1471-2369"}],"subject":[],"published":{"date-parts":[[2022,12,13]]},"assertion":[{"value":"5 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 December 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 December 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient received all information regarding this case report. Written informed consent for publication in BMC Nephrology was obtained from the patient. A copy of the consent form is available for review by the Editor of the journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"400"}}