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Immune thrombocytopenic purpura and acute liver injury after COVID-19 vaccine
  1. Adam Hines1,
  2. Janice Gloria Shen2,3,
  3. Coral Olazagasti1 and
  4. Shakil Shams1
  1. 1Hematology/Oncology, Long Island Jewish Medical Center Northwell Health Cancer Institute, New Hyde Park, New York, USA
  2. 2Hematology/Oncology, Long Island Jewish Medical Center Northwell Health Cancer Institute, Lake Success, New York, USA
  3. 3Division of Hematology-Oncology, Department of Medicine, Northwell Health, Manhasset, New York, USA
  1. Correspondence to Dr Adam Hines; adh9026{at}


A 26-year-old woman was sent to the emergency room by her primary care physician for a new petechial rash and thrombocytopenia 2 weeks after receiving the Moderna mRNA-1273 SARS-CoV-2 vaccine. Her hospital course was complicated by transaminitis. Her platelet count improved to normal on hospital day 5 after receiving intravenous steroids and intravenous immunoglobulin to treat her suspected diagnosis of immune thrombocytopenic purpura. Extensive workup for her thrombocytopenia and transaminitis was unremarkable including ruling out infectious, autoimmune and toxic causes. A liver biopsy was unrevealing and her transaminitis was improved on discharge. Although not proven, the temporal relationship of her vaccination with thrombocytopenia and abnormal liver enzymes points towards the Moderna mRNA-1273 SARS-CoV-2 vaccine as the most likely inciting factor.

  • immunological products and vaccines
  • hepatitis other
  • haematology (incl blood transfusion)
  • immunology
  • public health

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  • Contributors AH and JCS conceived the idea. AH, JCS and CO wrote the manuscript. SS approved, edited and provided expert opinion of the manuscript. SS, AH, JCS and CO also were involved with editing and finalising the manuscript.

  • 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.