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Rare disease
CASE REPORT
Epistaxis and gross haematuria with severe thrombocytopaenia associated with influenza vaccination
  1. Abdullah Almohammadi1,2,
  2. Michael S Lundin2,3,
  3. Calvin Abro2,3 and
  4. Borys Hrinczenko1,2
  1. 1 Hematology and Oncology, Michigan State University, Lansing, Michigan, USA
  2. 2 Internal Medicine, Sparrow Hospital, Lansing, Michigan, USA
  3. 3 Internal Medicine, Michigan State University, East Lansing, Michigan, USA
  1. Correspondence to Dr Michael S Lundin, lundinmi{at}msu.edu

Abstract

Epistaxis may be attributed to many causes during the winter including dry mucous membranes from low indoor humidity from heating. However, epistaxis may also be due to thrombocytopaenia. Immune thrombocytopaenia purpura (ITP) is an autoimmune disorder causing thrombocytopaenia. Viral infections sometimes lead to ITP. Vaccines, predominantly the measles-mumps-rubella vaccine, have been associated with the development of ITP. There are several published case reports regarding influenza vaccine induced ITP. However, an association between ITP and influenza vaccination has not been firmly proven yet. We report the case of an adult with three episodes of epistaxis, each within 1 week of receiving a yearly influenza trivalent inactivated vaccine, the last episode being more severe and also featuring gross haematuria.

  • immunological products and vaccines
  • general practice/family medicine
  • haematology (incl blood transfusion)
  • influenza
  • public health

https://doi.org/10.1136/bcr-2019-229423

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    Footnotes

    • Contributors AA wrote up the initial manuscript. MSL edited the manuscript significantly and added citations. CA was the junior resident who saw the patient and reviewed the manuscript. BH was the attending who saw this patient.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.