Autoimmune Cytopenias

Two clinicians from Advocate Aurora Health in Milwaukee have reported a case of widespread bleeding and petechiae in a 22-year-old healthy male 3 days post vaccination with the Pfizer‐BioNTech BNT16B2b2 mRNA vaccine. SARS‐CoV‐2 IgG testing, to rule out ITP caused by a previous COVID-19 infection, was negative. The patient had no personal or family history of bleeding or autoimmune disease. On day 6 post vaccination, a diagnosis of ITP was made based on his presentation, platelet count, and the exclusion of alternative causes. The authors said the patient, who has remained healthy since his discharge on day 6, may have had pre-existing ITP that became clinically apparent following the vaccine but noted that he “never manifested symptoms suggestive of autoimmune disease.” The case, they wrote, may serve “as a foundation for clinicians to evaluate future patients with suspected ITP."