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Hereditary thrombotic thrombocytopenic purpura and COVID‐19: Impacts of vaccination and infection in this rare disease

INTRODUCTION: Severe COVID‐19 is associated with an important increase of von Willebrand factor and mild lowering of ADAMTS13 activity that may, in the presence of a strong inflammatory reaction, increase the risk of acute thrombotic thrombocytopenic purpura (TTP). Although acute episodes of immune‐...

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Autores principales: Tarasco, Erika, von Krogh, Anne Sophie, Hrdlickova, Radomira, Braschler, Thomas R., Iwaniec, Teresa, Knöbl, Paul N., Hamada, Eriko, Pikovsky, Oleg, Farese, Stefan, Gutwein, Odit, Kessler, Petr, Schultz, Nina H., von Auer, Charis, Windyga, Jerzy, Friedman, Kenneth, Hrachovinova, Ingrid, George, James N., Matsumoto, Masanori, Schneppenheim, Reinhard, Lämmle, Bernhard, Kremer Hovinga, Johanna Anna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9585384/
https://www.ncbi.nlm.nih.gov/pubmed/36284639
http://dx.doi.org/10.1002/rth2.12814
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author Tarasco, Erika
von Krogh, Anne Sophie
Hrdlickova, Radomira
Braschler, Thomas R.
Iwaniec, Teresa
Knöbl, Paul N.
Hamada, Eriko
Pikovsky, Oleg
Farese, Stefan
Gutwein, Odit
Kessler, Petr
Schultz, Nina H.
von Auer, Charis
Windyga, Jerzy
Friedman, Kenneth
Hrachovinova, Ingrid
George, James N.
Matsumoto, Masanori
Schneppenheim, Reinhard
Lämmle, Bernhard
Kremer Hovinga, Johanna Anna
author_facet Tarasco, Erika
von Krogh, Anne Sophie
Hrdlickova, Radomira
Braschler, Thomas R.
Iwaniec, Teresa
Knöbl, Paul N.
Hamada, Eriko
Pikovsky, Oleg
Farese, Stefan
Gutwein, Odit
Kessler, Petr
Schultz, Nina H.
von Auer, Charis
Windyga, Jerzy
Friedman, Kenneth
Hrachovinova, Ingrid
George, James N.
Matsumoto, Masanori
Schneppenheim, Reinhard
Lämmle, Bernhard
Kremer Hovinga, Johanna Anna
author_sort Tarasco, Erika
collection PubMed
description INTRODUCTION: Severe COVID‐19 is associated with an important increase of von Willebrand factor and mild lowering of ADAMTS13 activity that may, in the presence of a strong inflammatory reaction, increase the risk of acute thrombotic thrombocytopenic purpura (TTP). Although acute episodes of immune‐mediated TTP associated with COVID‐19 or SARS‐CoV‐2 vaccination have been reported, data about clinical evolution of hereditary TTP (hTTP) during the pandemic are scarce. METHOD: We conducted a survey among adult patients of the International Hereditary TTP Registry about SARS‐CoV‐2 vaccination, COVID‐19, and occurrence of acute hTTP episodes. RESULTS: Of 122 adult hTTP patients invited to participate, 86 (70.5%) responded. Sixty‐five had been vaccinated (75.6%), of which 14 had received in addition a booster, resulting in 139 individual vaccine shots. Although vaccinations in patients on plasma prophylaxis were done within 1 week of the last plasma infusion, all 23 patients treated with plasma on demand were vaccinated without prior plasma infusions. One patient on uninterrupted weekly plasma infusions presented within 3 days from his second vaccination with neurological symptoms and computed tomography scan 9 days later showed subacute ischemic/hemorrhagic frontal lobe infarction. A second male patient developed acute myocarditis after his second dose of mRNA‐1273 vaccine. Twelve (14%) patients had COVID‐19, associated with an acute hTTP episode in three of them: one patient had a transient ischemic attack, one a stroke, and a pregnant woman was hospitalized to intensify plasma treatment. DISCUSSION: The risk of an acute episode triggered by COVID‐19 seems higher than following vaccination in hTTP patients, who can be safely vaccinated against SARS‐CoV‐2.
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spelling pubmed-95853842022-10-24 Hereditary thrombotic thrombocytopenic purpura and COVID‐19: Impacts of vaccination and infection in this rare disease Tarasco, Erika von Krogh, Anne Sophie Hrdlickova, Radomira Braschler, Thomas R. Iwaniec, Teresa Knöbl, Paul N. Hamada, Eriko Pikovsky, Oleg Farese, Stefan Gutwein, Odit Kessler, Petr Schultz, Nina H. von Auer, Charis Windyga, Jerzy Friedman, Kenneth Hrachovinova, Ingrid George, James N. Matsumoto, Masanori Schneppenheim, Reinhard Lämmle, Bernhard Kremer Hovinga, Johanna Anna Res Pract Thromb Haemost Original Articles INTRODUCTION: Severe COVID‐19 is associated with an important increase of von Willebrand factor and mild lowering of ADAMTS13 activity that may, in the presence of a strong inflammatory reaction, increase the risk of acute thrombotic thrombocytopenic purpura (TTP). Although acute episodes of immune‐mediated TTP associated with COVID‐19 or SARS‐CoV‐2 vaccination have been reported, data about clinical evolution of hereditary TTP (hTTP) during the pandemic are scarce. METHOD: We conducted a survey among adult patients of the International Hereditary TTP Registry about SARS‐CoV‐2 vaccination, COVID‐19, and occurrence of acute hTTP episodes. RESULTS: Of 122 adult hTTP patients invited to participate, 86 (70.5%) responded. Sixty‐five had been vaccinated (75.6%), of which 14 had received in addition a booster, resulting in 139 individual vaccine shots. Although vaccinations in patients on plasma prophylaxis were done within 1 week of the last plasma infusion, all 23 patients treated with plasma on demand were vaccinated without prior plasma infusions. One patient on uninterrupted weekly plasma infusions presented within 3 days from his second vaccination with neurological symptoms and computed tomography scan 9 days later showed subacute ischemic/hemorrhagic frontal lobe infarction. A second male patient developed acute myocarditis after his second dose of mRNA‐1273 vaccine. Twelve (14%) patients had COVID‐19, associated with an acute hTTP episode in three of them: one patient had a transient ischemic attack, one a stroke, and a pregnant woman was hospitalized to intensify plasma treatment. DISCUSSION: The risk of an acute episode triggered by COVID‐19 seems higher than following vaccination in hTTP patients, who can be safely vaccinated against SARS‐CoV‐2. John Wiley and Sons Inc. 2022-10-21 /pmc/articles/PMC9585384/ /pubmed/36284639 http://dx.doi.org/10.1002/rth2.12814 Text en © 2022 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Tarasco, Erika
von Krogh, Anne Sophie
Hrdlickova, Radomira
Braschler, Thomas R.
Iwaniec, Teresa
Knöbl, Paul N.
Hamada, Eriko
Pikovsky, Oleg
Farese, Stefan
Gutwein, Odit
Kessler, Petr
Schultz, Nina H.
von Auer, Charis
Windyga, Jerzy
Friedman, Kenneth
Hrachovinova, Ingrid
George, James N.
Matsumoto, Masanori
Schneppenheim, Reinhard
Lämmle, Bernhard
Kremer Hovinga, Johanna Anna
Hereditary thrombotic thrombocytopenic purpura and COVID‐19: Impacts of vaccination and infection in this rare disease
title Hereditary thrombotic thrombocytopenic purpura and COVID‐19: Impacts of vaccination and infection in this rare disease
title_full Hereditary thrombotic thrombocytopenic purpura and COVID‐19: Impacts of vaccination and infection in this rare disease
title_fullStr Hereditary thrombotic thrombocytopenic purpura and COVID‐19: Impacts of vaccination and infection in this rare disease
title_full_unstemmed Hereditary thrombotic thrombocytopenic purpura and COVID‐19: Impacts of vaccination and infection in this rare disease
title_short Hereditary thrombotic thrombocytopenic purpura and COVID‐19: Impacts of vaccination and infection in this rare disease
title_sort hereditary thrombotic thrombocytopenic purpura and covid‐19: impacts of vaccination and infection in this rare disease
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9585384/
https://www.ncbi.nlm.nih.gov/pubmed/36284639
http://dx.doi.org/10.1002/rth2.12814
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