Secondary thrombocytopenia after SARS-CoV-2 vaccine: Report of a case of hemorrhage and hematoma after minor oral surgery

Luigi Angelo Vaira; Luigi Podda; Piero Doneddu; Maria Grazia Careddu; Claudio Fozza; Giacomo De Riu

doi:10.1016/j.jormas.2021.07.010

Secondary thrombocytopenia after SARS-CoV-2 vaccine: Report of a case of hemorrhage and hematoma after minor oral surgery

J Stomatol Oral Maxillofac Surg. 2022 Apr;123(2):95-97. doi: 10.1016/j.jormas.2021.07.010. Epub 2021 Jul 24.

Authors

Luigi Angelo Vaira¹, Luigi Podda², Piero Doneddu³, Maria Grazia Careddu², Claudio Fozza⁴, Giacomo De Riu³

Affiliations

¹ Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari (Head: Prof. Giacomo De Riu), Italy; Biomedical Science PhD School, Biomedical Science Department, University of Sassari (Head: Prof. Margherita Maioli), Italy. Electronic address: lavaira@uniss.it.
² Blood Disease Operative Unit, University Hospital of Sassari, (Head: Prof. Claudio Fozza), Italy.
³ Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari (Head: Prof. Giacomo De Riu), Italy.
⁴ Blood Disease Operative Unit, University Hospital of Sassari, (Head: Prof. Claudio Fozza), Italy; Blood Disease Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, (Head: Prof. Claudio Fozza), Italy.

Abstract

The authors present the case of a patient who underwent the removal of a small bluish lesion of the cheek. After discharge, the patient presented with profuse bleeding and hematoma of the cheek. Blood tests revealed severe secondary immune thrombocytopenia (SITP). SITP was probably triggered by the anti-SARS-CoV-2 Pfizer vaccine, which was inoculated to the patient 3 days before the lesion appeared and 12 days before surgery. The authors' aim is to inform colleagues about this possible, rare, adverse effect of the vaccine. In all patients who have recently undergone the COVID-19 vaccine and who present lesions suspected to be due to blood extravasation of the oral mucosa or unjustified gingival bleeding it is advisable to request a blood count before surgery.

Keywords: COVID-19; Coronavirus; Oral surgery; SARS-CoV-2; Secondary thrombocytopenia; Thrombocytopenia; Vaccine.

Publication types

Case Reports

MeSH terms

COVID-19 Vaccines / adverse effects
COVID-19*
Hematoma / diagnosis
Hematoma / etiology
Hemorrhage
Humans
Oral Surgical Procedures* / adverse effects
SARS-CoV-2
Thrombocytopenia* / chemically induced
Thrombocytopenia* / diagnosis

Substances

COVID-19 Vaccines