Tuberc Respir Dis > Accepted Articles
DOI: https://doi.org/10.4046/trd.2022.0050    [Accepted]
Published online July 13, 2022.
Pulmonary embolism and inferior vena cava thrombosis in a young male patient after mRNA-1273 (Moderna) immunization: A case report
Eui Young Ahn, Hayoung Choi, Yun Su Sim, Tae Rim Shin, Taeehee Kim
Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
Correspondence:  Taeehee Kim,
Email: sosom02@naver.com
Received: 7 May 2022   • Revised: 15 June 2022   • Accepted: 6 July 2022
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, the safety and efficacy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccines have been proven, and vaccines have been actively administered worldwide. However, thrombosis with thrombocytopenia (TTS) is a rare side effect of adenoviral vector vaccine administration. The mechanism of TTS is that adenovirus vaccines stimulate the production of autoantibodies to platelet factor 4 (PF4) that activate platelets and induce thrombosis. Additionally, cases of cerebral venous thrombosis after BNT162b2 (Pfizer-BioNTech) mRNA vaccination have been reported. However, the mechanism of thrombosis after mRNA vaccination is still unknown. We present a case of venous thromboembolism (VTE) that developed after the second dose of mRNA-1273 (Moderna) immunization in a young male patient with no risk factors for thrombosis. In addition, we confirmed that anti-heparin PF4 IgG was negative in this case. This is the first report suggesting that thrombosis after mRNA vaccination is caused by different mechanism from TTS.
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