Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273
Vaccination plays an important role during the COVID-19 pandemic. Vaccine-induced thrombotic thrombocytopenia (VITT) is a major adverse effect that could be lethal. For cancer patients, cancer-related thromboembolism is another lethal complication. When cancer patients receive their COVID-19 vaccine...
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| Format: | Article |
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Frontiers Media S.A.
2021-11-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.772424/full |
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| author | Po-Hsu Su Yi-Ching Yu Wen-Hsin Chen Hsuan-Ching Lin Yih-Ting Chen Ming-Huei Cheng Yen-Min Huang Yen-Min Huang |
| author_facet | Po-Hsu Su Yi-Ching Yu Wen-Hsin Chen Hsuan-Ching Lin Yih-Ting Chen Ming-Huei Cheng Yen-Min Huang Yen-Min Huang |
| author_sort | Po-Hsu Su |
| collection | DOAJ |
| description | Vaccination plays an important role during the COVID-19 pandemic. Vaccine-induced thrombotic thrombocytopenia (VITT) is a major adverse effect that could be lethal. For cancer patients, cancer-related thromboembolism is another lethal complication. When cancer patients receive their COVID-19 vaccines, the following thromboembolic events will be more complicated. We presented a case recently diagnosed with pancreatic cancer, who had received the mRNA-1273 (Moderna) vaccination 12 days prior. Ischemic stroke and VITT were also diagnosed. We aggressively treated the patient with steroids, immunoglobulin, and plasma exchange. The titer of anti-platelet factor four and d-dimer level decreased, but the patient ultimately died. The complicated condition of VITT superimposed cancer-related thromboembolism was considered. To our knowledge, only one case of mRNA-1273 related VITT was reported, and this case study was the first to report a cancer patient who was diagnosed with VITT after mRNA-1273 vaccination. Therefore, when the need for vaccination among cancer patients increased under the current COVID-19 pandemic, the possible risk of VITT for cancer patients should be carefully managed. Further studies of the risk evaluation of the COVID-19 vaccine in cancer patients might be required in the future. |
| first_indexed | 2024-12-20T23:33:43Z |
| format | Article |
| id | doaj.art-f97d5a7e3b484e1d8338289812a8be22 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-20T23:33:43Z |
| publishDate | 2021-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-f97d5a7e3b484e1d8338289812a8be222022-12-21T19:23:15ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-11-01810.3389/fmed.2021.772424772424Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273Po-Hsu Su0Yi-Ching Yu1Wen-Hsin Chen2Hsuan-Ching Lin3Yih-Ting Chen4Ming-Huei Cheng5Yen-Min Huang6Yen-Min Huang7Division of Hematology and Oncology, Department of Internal Medicine, Hemophilia and Thrombosis Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanDepartment of Neurology, Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanDivision of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanDivision of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanDepartment of Plastic Surgery, Center of Tissue Engineering, Chang Gung Memorial Hospital at Linkou and College of Medicine, Chang Gung University, Taoyuan, TaiwanDivision of Hematology and Oncology, Department of Internal Medicine, Hemophilia and Thrombosis Treatment Center, Chang Gung Memorial Hospital at Keelung, Keelung, TaiwanInstitute of Medicine, Chung Shan Medical University, Taichung, TaiwanVaccination plays an important role during the COVID-19 pandemic. Vaccine-induced thrombotic thrombocytopenia (VITT) is a major adverse effect that could be lethal. For cancer patients, cancer-related thromboembolism is another lethal complication. When cancer patients receive their COVID-19 vaccines, the following thromboembolic events will be more complicated. We presented a case recently diagnosed with pancreatic cancer, who had received the mRNA-1273 (Moderna) vaccination 12 days prior. Ischemic stroke and VITT were also diagnosed. We aggressively treated the patient with steroids, immunoglobulin, and plasma exchange. The titer of anti-platelet factor four and d-dimer level decreased, but the patient ultimately died. The complicated condition of VITT superimposed cancer-related thromboembolism was considered. To our knowledge, only one case of mRNA-1273 related VITT was reported, and this case study was the first to report a cancer patient who was diagnosed with VITT after mRNA-1273 vaccination. Therefore, when the need for vaccination among cancer patients increased under the current COVID-19 pandemic, the possible risk of VITT for cancer patients should be carefully managed. Further studies of the risk evaluation of the COVID-19 vaccine in cancer patients might be required in the future.https://www.frontiersin.org/articles/10.3389/fmed.2021.772424/fullmessenger RNA-1273vaccine-induced immune thrombotic thrombocytopeniapancreatic cancerCOVID-19platelet factor 4 (PF4) |
| spellingShingle | Po-Hsu Su Yi-Ching Yu Wen-Hsin Chen Hsuan-Ching Lin Yih-Ting Chen Ming-Huei Cheng Yen-Min Huang Yen-Min Huang Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273 Frontiers in Medicine messenger RNA-1273 vaccine-induced immune thrombotic thrombocytopenia pancreatic cancer COVID-19 platelet factor 4 (PF4) |
| title | Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273 |
| title_full | Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273 |
| title_fullStr | Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273 |
| title_full_unstemmed | Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273 |
| title_short | Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273 |
| title_sort | case report vaccine induced immune thrombotic thrombocytopenia in a pancreatic cancer patient after vaccination with messenger rna 1273 |
| topic | messenger RNA-1273 vaccine-induced immune thrombotic thrombocytopenia pancreatic cancer COVID-19 platelet factor 4 (PF4) |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.772424/full |
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