Case Report: Vaccine-Induced Immune Thrombotic Thrombocytopenia in a Pancreatic Cancer Patient After Vaccination With Messenger RNA−1273

Po Hsu Su, Yi Ching Yu, Wen Hsin Chen, Hsuan Ching Lin, Yih Ting Chen, Ming Huei Cheng, Yen Min Huang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

16 Scopus citations

Abstract

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.

Original languageEnglish
Article number772424
JournalFrontiers in Medicine
Volume8
DOIs
StatePublished - 01 11 2021

Bibliographical note

Publisher Copyright:
© Copyright © 2021 Su, Yu, Chen, Lin, Chen, Cheng and Huang.

Keywords

  • COVID-19
  • messenger RNA-1273
  • pancreatic cancer
  • platelet factor 4 (PF4)
  • vaccine-induced immune thrombotic thrombocytopenia

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