@article {Leee246049, author = {Hui Ping Lee and Veena Selvaratnam and Jay Suriar Rajasuriar}, title = {Thrombotic thrombocytopenic purpura after ChAdOx1 nCoV-19 vaccine}, volume = {14}, number = {10}, elocation-id = {e246049}, year = {2021}, doi = {10.1136/bcr-2021-246049}, publisher = {BMJ Specialist Journals}, abstract = {A 50-year-old Indian woman presented with acute dysphasia, left upper limb numbness and thrombocytopenia 12 days after receiving the ChAdOx1 nCoV-19 vaccine (AstraZeneca/Vaxzevria). MRI of the brain was unremarkable. Microangiopathic haemolytic anaemia with thrombocytopenia was noted on her peripheral blood film. A diagnosis of thrombotic thrombocytopenic purpura (TTP) was confirmed through the findings of absent ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) activity and markedly raised titre of ADAMTS13 autoantibodies. Prompt treatment with plasma exchange, adjunctive steroids and rituximab was commenced. A remission of TTP was achieved and she was discharged 3 weeks after admission. While other immune-mediated conditions have been documented after receipt of the vaccine, this report highlights the first case of immune-mediated TTP diagnosed after administration of the ChAdOx1 nCoV-19 vaccine.}, URL = {https://casereports.bmj.com/content/14/10/e246049}, eprint = {https://casereports.bmj.com/content/14/10/e246049.full.pdf}, journal = {BMJ Case Reports CP} }