Age: 70.0
Sex: M
Vaccine: COVID19
Symptoms: Blood folate, Blood lactate dehydrogenase, Blood pressure measurement, Body temperature, COVID-19
Clinical narrative: Immune Thrombocytopenic Purpura; COVID-19; This literature-non-study case was reported in a literature article and describes the occurrence of IMMUNE THROMBOCYTOPENIA (Immune Thrombocytopenic Purpura) in a 70-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below.      Concurrent medical conditions included Hypertension, Hyperlipidemia and Gout. Concomitant products included METOPROLOL, ATORVASTATIN and ALLOPURINOL for an unknown indication.   On an unknown date, the patient received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form and first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced IMMUNE THROMBOCYTOPENIA (Immune Thrombocytopenic Purpura) (seriousness criteria hospitalization and medically significant) and COVID-19 (COVID-19). The patient was treated with DEXAMETHASONE (intravenous) at an unspecified dose and frequency; IMMUNOGLOBULINS NOS (IMMUNOGLOBULIN I.V) (intravenous) at a dose of 1 gram per kilogram 2 doses and PLATELETS at a dose of one unit. At the time of the report, IMMUNE THROMBOCYTOPENIA (Immune Thrombocytopenic Purpura) was resolving and COVID-19 (COVID-19) had resolved.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood folate: Normal. On an unknown date, Blood lactate dehydrogenase: slightly elevated. On an unknown date, Blood pressure measurement: 120/79 mmHg. On an unknown date, Body temperature: 97.9 F. On an unknown date, HIV test: Normal. On an unknown date, Haptoglobin: Normal. On an unknown date, Heart rate: 80 heart beats per minute. On an unknown date, Hepatitis viral test: Normal. On an unknown date, Oxygen saturation: normal oxygen saturation on ambient air.. On an unknown date, Physical examination: physical examination findings were normal except for the skin examination, which showed scattered petechiae located mainly in the upper chest and upper extremities.. On an unknown date, Platelet count (130-400 10 thousand per microlitre): 1 10 thousand per microlitre, 14 10 thousand per microlitre, 2 10 thousand per microlitre, 89 10 thousand per microlitre at hospital discharge after IV immunoglobulin, platelet counts at his outpatient follow-up visits remained normal and ranged between 243 and 333 x10^3/µL (reference ranges of 130-400x10^3 /µL). and maintained stable platelet counts for six months post-vaccination. On an unknown date, Respiratory rate: 14 breaths per minute. On an unknown date, SARS-CoV-2 test: Negative. On an unknown date, Vital signs measurement: vital signs did not reveal orthostatic hypotension, and his mentation was normal.. On an unknown date, Vitamin B12: Normal.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Patient presented with a three-day history of spontaneous bruising over his upper chest, trunk, and arms and red streaks in his saliva.   Two weeks prior, he was diagnosed with mild symptomatic COVID-19 infection, when he presented with cough, fatigue, and body aches. For COVID-19 patient was prescribed Paxlovid but did not end up taking it, as he filled it belatedly past the therapeutic window.  Three months following the diagnosis of COVID-19 infection, the patient successfully received the bivalent Pfizer mRNA vaccination and maintained stable platelet counts for six months post-vaccination.  Reported that patient received mRNA vaccinations prior to COVID-19 infection and following infection without the occurrence of thrombocytopenia or other adverse reactions.  Company Comment: This is a literature non-study case concerning a 70-year-old, male patient with Concurrent medical conditions of hypertension, Hyperlipidemia and Gout and concomitant products that included METOPROLOL, ATORVASTATIN and ALLOPURINOL, who experienced the serious (due to medically significant and hospitalization unexpected, AESI of Immune thrombocytopenia (reported as Immune Thrombocytopenic Purpura) and the non-serious unexpected event COVID-19. The event Immune thrombocytopenia occurred after a dose of mRNA-1273 vaccine (dose date and event date not reported), and the event COVID-19 occurred one year after the booster dose of COVID-19 vaccination (date not reported). Patient presented with a three-day history of spontaneous bruising over his upper chest, trunk, and arms and red streaks in his saliva. Two weeks prior, he was diagnosed with mild symptomatic COVID-19 infection, when he presented with cough, fatigue, and body aches. For COVID-19 patient was prescribed Paxlovid but did not end up taking it, as he filled it belatedly past the therapeutic window. Three months following the diagnosis of COVID-19 infection, the patient successfully received the bivalent Pfizer mRNA vaccination and maintained stable platelet counts for six months post-vaccination.  Relevant diagnostic tests included Platelet count of 1 x10^3 /µL, 14 x 10^3 /µL, 2 x 10^3 /µL, 89 x 10^3 /µL at hospital discharge after IV immunoglobulin, platelet counts at his outpatient follow-up visits remained normal and ranged between 243 and 333 x 10^3/µL (reference ranges of 130-400 x10^3 /µL) and maintained stable platelet counts for six months post-vaccination. Physical examination findings were normal except for the skin examination, which showed scattered petechiae located mainly in the upper chest and upper extremities. The outcome of the event Immune thrombocytopenia was reported as recovering. The outcome of the event COVID-19 was reported as recovered. The patient was treated with dexamethasone, imunoglobulin and platelets. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.  Most recent FOLLOW-UP information incorporated above includes: On 31-May-2023: Follow up received by safety on 31-MAY-2023 has email with full text article and contains significant information: Reporter information, literature information, medical history, lab data, suspect details, concomitant and treatment medications, event details and Narrative updated.