SHM Converge Scientific Abstract ePoster Gallery-Severe Aplastic Anemia Post Covid-19 Vaccination in Young Male Found to Be a Carrier of Fanconi Anemia Type C

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This case report describes a 38-year-old man who developed severe aplastic anemia (AA) shortly after receiving his second Pfizer-BioNTech COVID-19 vaccine dose. Seventeen days after vaccination, he presented with 4 days of mucocutaneous bleeding and petechiae. His platelet count had dropped dramatically to 2,000/μL from normal levels 2 months earlier. Further evaluation showed pancytopenia, with worsening neutropenia and an ANC falling to zero.<br /><br />Workup for other causes of bone marrow failure was negative, including viral serologies, ANA, PNH testing, and ADAMTS13 activity. Bone marrow biopsy revealed profound hypocellularity (5%), consistent with aplastic marrow, and flow cytometry showed no malignancy. He required platelet transfusions, but the response was transient. His hospital course was complicated by neutropenic fever treated with broad-spectrum antibiotics, and he ultimately underwent allogeneic hematopoietic stem cell transplantation.<br /><br />During transplant evaluation, he was found to be a carrier of Fanconi anemia type C. The authors note that this carrier status is unlikely to fully explain his marrow failure, since Fanconi anemia usually presents in early childhood and he was only a carrier, not affected disease. They argue that the timing of his illness, along with a previously normal CBC and negative alternative workup, raises concern for a possible causal relationship between COVID-19 vaccination and AA.<br /><br />The report emphasizes that hematologic adverse events after COVID-19 vaccination appear rare, but autoimmune cytopenias and occasional aplastic anemia have been described. The authors call for more research to clarify whether a true association exists, while also stressing the need to weigh potential risks against the benefits of vaccination, including in individuals who may be carriers for inherited bone marrow failure syndromes.

Asset Subtitle

Ross Lavine

Meta Tag

Author List Alexandra Gottdiener, Anesha White, Anna-Belle M. Robertson, Hassan Alkhatatneh, Jalisa Carvalho, Jason D. Lofters, Jodi-Ann S. Smith, Michael H. Basir, Ross Lavine

Category Clinical Vignettes

Concept Severe Aplastic Anemia

Concept Pancytopenia

Concept Bone marrow failure

Concept Bone Marrow Biopsy

Concept Allogeneic Hematopoietic Stem Cell Transplant

Distinguished Non-Finalist

Presenter Organization Englewood Health

Presenting Author Ross Lavine

Track Adult

Keywords

aplastic anemia

COVID-19 vaccination

Pfizer-BioNTech

pancytopenia

thrombocytopenia

bone marrow failure

neutropenia

allogeneic stem cell transplantation

Fanconi anemia carrier

mucocutaneous bleeding

Severe Aplastic Anemia

Pancytopenia

Bone marrow failure

Bone Marrow Biopsy

Allogeneic Hematopoietic Stem Cell Transplant