Title: Rapid
response to mycophenolate mofetil in combination with romiplostim in a
case of severe refractory immune thrombocytopenia post COVID-19
vaccination
Snigdha Nutalapati, Gerhard C. Hildebrandt
Snigdha Nutalapati, MD (snutalapati@uky.edu)
University of Kentucky College of Medicine, Division of Hematology and
Oncology, Lexington, KY, USA
Gerhard C. Hildebrandt, MD (gerhard.hildebrandt@uky.edu)
University of Kentucky College of Medicine, Division of Hematology and
Oncology, Lexington, KY, USA
Key Words: Immune thrombocytopenia, SARS -CoV2 vaccination, Romiplostim,
Mycophenolate mofetil
Key Clinical Message: Though it could not entirely be determined if ITP
post COVID vaccination is truly causative or mere coincidence, it should
be reported and considered as a differential in all patients who present
with thrombocytopenia post COVID vaccination.
Contributions:
Snigdha Nutalapati contributed to the case management and manuscript
writing.
Gerhard C. Hildebrandt contributed to the case management, manuscript
writing and final approval.
Conflict of Interest disclosure statements:
The authors report no conflict of interest.
Data availability statement:
Data sharing not applicable - no new data generated.
Corresponding Author:
Gerhard C. Hildebrandt, MD FACP
Professor of Medicine
Division Chief, Hematology and Blood & Marrow Transplantation
University of Kentucky College of Medicine
Lexington, KY, USA
Email: gerhard.hildebrandt@uky.edu
predisposed patients. It is advisable to warn patients with CAD or other
immune cytopenias
and monitor the occurrence of these phenomena when they receive the
vaccine. It would be
useful to explore possible immunosuppressive therapy regimens to control
flares, as well as to
estimate the impact of these drugs on the vaccine serological response.
References
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Ethics declaration: verbal consent was obtained from the patient for the
publication of this
report.
Data availability: Other laboratory or clinical data is available from
the corresponding author
on reasonable request.
Author contributions:
M.J.G is the consultant hematologist responsible for the patient, P.L.L
and M.J.G did the
bibliographic research, wrote the clinical case and its discussion.
V.K.K, T.N.MC, J.M.A and
V.C.A provided technical guidance and advice. J.C.C, A.M.B and N.T.C
were involved in critical
revision of the report. L.J.FJ and G.G.V helped with the literature
review and provided overall