Introduction:
Immune mediated thrombocytopenia (ITP) is a autoimmune condition
characterized by low platelet counts and wide range of clinical
manifestations from asymptomatic presentation to major bleeding
manifestations. Vaccine mediated secondary ITP is rare and is associated
with influenza, measles mumps rubella (MMR), hepatitis A and B
vaccination. Most patients respond with steroids and intravenous
immunoglobulin.1 We hereby report a case of a
26-year-old female with severe refractory ITP who presented with
multiple active bleeding sites leading to a significant drop in
hemoglobin post second dose of COVID vaccination. She was refractory to
treatment with steroids and intravenous immunoglobulin(IVIG) and was
eventually treated with combination of romiplostim and mycophenolate
mofetil with which her counts improved dramatically.