Dyspneic and febrile

Immune thrombotic thrombocytopenic purpura (iTTP) relapse in a 70-year-old man with a history of stroke, left ventricular aneurysm thrombosis (on chronic anticoagulation), and chronic kidney disease (baseline creatinine level: 130 mol/L). Seven years ago, iTTP was initially identified. The patient developed symptoms 7 days after receiving his first dose of the Moderna COVID-19 vaccination and 3–4 days after encountering a COVID-19-infected person. Upon admission to the hospital, the patient was dyspneic and febrile, and a chest X-ray (CXR) suggested left lower lobe pneumonia. Microangiopathic haemolytic anaemia, thrombocytopenia, AKI, and increased troponin were found in the blood test. His oxygen needs rose on day three of hospitalisation, necessitating a transfer to critical care for non-invasive respiratory assistance.