Dear Editor,We would like to share ideas on the publication ‘Abdominal pain and bilateral adrenal haemorrhage of coronavirus disease 2019 (COVID-19) vaccine-induced immune thrombotic thrombocytopenia’. Lin et al. mentioned about possible clinical association between adrenal problem and vaccine-induced immune thrombotic thrombocytopenia(VITT). We concur that the case has adrenal problem and the incidence was observed after COVID-19 vaccination. The adrenal problem might or might not be a side effect of COVID-19 immunization. The VITT might be a possible pathogenesis. Nevertheless, there is also other possible cause. Concurrent medical problem after COVID-19 vaccination might exist and might induce adrenal problem. A possible concurrent disorder in a COVID-19 vaccine recipient is dengue. The concurrent dengue might manifest clinical picture like VITT and can cause adrenal problem.
Author contributions
R.M. (50%): substantial contributions to study conception and design, acquisition of data and analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version of the article to be published. V.W. (50%): substantial contributions to study conception and design, acquisition of data and analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version of the article to be published.Conflict of interest. The authors ask for waiving for any charge relating to this correspondence.