Transient Pseudothrombocytopenia Detected 8 Months After COVID-19 Vaccination

Abstract Pseudothrombocytopenia is an in vitro phenomenon of platelet aggregation due to conformational changes and exposure of cryptic antigens on the platelet surface caused by anticoagulants, leading to the aggregation of platelets and falsely lower automated platelet counts. Although it has no clinical relevance, it can lead to unnecessary fear, diagnostic errors, or unnecessary tests and interventions when unrecognized. Pseudothrombocytopenia was detected in a 25-year-old woman 8 months after the second dose of mRNA COVID-19 vaccine, BNT162b2. The pseudothrombocytopenia was transient and the duration was shorter than 3 months. As pseudothromobocytopenia is not detected unless blood is drawn for other objectives, it is difficult to determine its true occurrence among recipients of vaccines. This case shows that pseudothrombocytopenia may develop transiently even months after COVID-19 vaccination and should be considered when thrombocytopenia is found in recipients of the vaccine to avoid unnecessary fear, diagnostic errors, or unnecessary tests and interventions.