Abstract：
Thrombotic thrombocytopenic purpura (TTP) is a thrombotic microangiopathy that is deadly if not treated promptly. The treatment of choice in patients presenting with TTP is plasma exchanges. However, immunosuppressive therapy and caplacizumab have significantly improved outcomes in TTP. This microangiopathy is classically divided into 2 entities: hereditary and acquired TTP (aTTP), caused by an autoantibody against ADAMTS 13. We present a case study of a patient wth TTP occurring after a second dose of the BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine along with a review of the literature. A 55-year-old patient presented with gastrointestinal symptoms, anemia, and severe thrombocytopenia. The blood film revealed the presence of schistocytes. A diagnosis of aTTP was established because the patient had severe ADAMTS 13 deficiency and autoantibodies against ADAMTS 13 were positive. This episode occurred 10 days after the patient received the COVID-19 vaccine. The patient received plasma exchanges, prednisone, rituximab, and caplacizumab and achieved complete remission. Ten patients with aTTP induced by the COVID-19 vaccine have been reported in the literature. Most of these situations occurred after the second dose of COVID-19 vaccine, and 7 patients were noted to have received the BNT162b2 vaccine. Caplacizumab was used in 6 patients, and complete remission was achieved in 8 patients.
摘要：
血栓性血小板减少性紫癜（TTP）是一种血栓性微血管病，如果不及时治疗会致命。TTP患者的治疗选择是血浆置换。然而,免疫抑制治疗和caplacizumab可显著改善TTP的预后.这种微血管病通常分为2个实体：遗传性和获得性TTP（aTTP），由针对ADAMTS13的自身抗体引起。我们介绍了一名患者在第二剂BNT162b2(Pfizer-BioNTech)COVID-19疫苗后发生TTP的案例研究，并回顾了文献。一名55岁的患者出现胃肠道症状，贫血,和严重的血小板减少症.血膜显示存在分裂细胞。由于患者患有严重的ADAMTS13缺乏症，并且针对ADAMTS13的自身抗体呈阳性，因此确定了aTTP的诊断。这一事件发生在患者接受COVID-19疫苗后10天。病人接受了血浆交换,泼尼松,利妥昔单抗,和caplacizumab并达到完全缓解。文献中报道了10例COVID-19疫苗诱导的aTTP患者。这些情况大多发生在第二剂COVID-19疫苗之后，7名患者接受了BNT162b2疫苗。卡普拉斯单抗用于6例患者，8例患者完全缓解。
