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Review
. 2014 Dec;60(2-3):226-35.
doi: 10.1007/s12026-014-8597-x.

Immune thrombocytopenic purpura (ITP) associated with vaccinations: a review of reported cases

Carlo Perricone  1 , Fulvia Ceccarelli, Gideon Nesher, Elisabetta Borella, Qasim Odeh, Fabrizio Conti, Yehuda Shoenfeld, Guido Valesini
Affiliations
Review

Immune thrombocytopenic purpura (ITP) associated with vaccinations: a review of reported cases

Carlo Perricone et al. Immunol Res. 2014 Dec.

Abstract

Immune thrombocytopenic purpura (ITP) is an autoimmune condition characterized by low platelet count with mucocutaneous and other bleedings. Clinical manifestations may range from spontaneous formation of purpura and petechiae, especially on the extremities, to epistaxis, bleeding at the gums or menorrhagia, any of which occur usually if the platelet count is below 20,000 per μl. A very low count may result in the spontaneous formation of hematomas in the mouth or on other mucous membranes. Fatal complications, including subarachnoid or intracerebral, lower gastrointestinal or other internal bleeding can arise due to an extremely low count. Vaccines may induce ITP by several mechanisms. Vaccine-associated autoimmunity may stem not only from the antigen-mediated responses but also from other constituents of the vaccine, such as yeast proteins, adjuvants, and preservatives diluents. The most likely is through virally induced molecular mimicry. The binding of pathogenic autoantibodies to platelet and megakaryocytes may cause thrombocytopenia by different mechanisms, such as opsonization, direct activation of complement, or apoptotic pathways. The autoantibodies hypothesis is not sufficient to explain all ITP cases: In the anti-platelet antibody-negative cases, a complementary mechanism based on T cell immune-mediated mechanism has been suggested. In particular, T cell subsets seem dysregulated with an increased production of pro-inflammatory cytokines, as IFN-γ and TNF, and chemokines, as CXCL10. Vaccines are one of the most striking discoveries in human history that changed dramatically life expectancy. Nonetheless, the occurrence of adverse events and autoimmune phenomena has been described following vaccination, and ITP may represent one of this.

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References

    1. Acta Paediatr. 1993 Mar;82(3):267-70 - PubMed
    1. Diabet Med. 2012 Jan;29(1):88-9 - PubMed
    1. Hematol Oncol Clin North Am. 2009 Dec;23(6):1239-49 - PubMed
    1. Haematologica. 2011 Oct;96(10):1560-4 - PubMed
    1. Nat Med. 2003 Sep;9(9):1123-4 - PubMed

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