A case of thrombocytopenia and multiple thromboses after vaccination with ChAdOx1 nCoV-19 against SARS-CoV-2
© 2021 by The American Society of Hematology..
Recently, reports of severe thromboses, thrombocytopenia, and hemorrhage in persons vaccinated with the chimpanzee adenovirus-vectored vaccine (ChAdOx1 nCoV-19, AZD1222, Vaxzevria; Oxford/AstraZeneca) against severe acute respiratory syndrome coronavirus 2 have emerged. We describe an otherwise healthy 30-year-old woman who developed thrombocytopenia, ecchymosis, portal vein thrombosis, and cerebral venous sinus thrombosis the second week after she received the ChAdOx1 nCoV-19 vaccine. Extensive diagnostic workup for thrombosis predispositions showed heterozygosity for the prothrombin mutation, but no evidence of myeloproliferative neoplasia or infectious or autoimmune diseases. Her only temporary risk factor was long-term use of oral contraceptive pills (OCPs). Although both the prothrombin mutation and use of OCPs predispose to portal and cerebral vein thrombosis, the occurrence of multiple thromboses within a short time and the associated pattern of thrombocytopenia and consumption coagulopathy are highly unusual. A maximum 4T heparin-induced thrombocytopenia (HIT) score and a positive immunoassay for anti-platelet factor 4/heparin antibodies identified autoimmune HIT as a potential pathogenic mechanism. Although causality has not been established, our case emphasizes the importance of clinical awareness. Further studies of this potentially new clinical entity have suggested that it should be regarded as a vaccine-induced immune thrombotic thrombocytopenia.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:5 |
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| Enthalten in: |
Blood advances - 5(2021), 12 vom: 22. Juni, Seite 2569-2574 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tølbøll Sørensen, Anne Louise [VerfasserIn] |
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| Links: |
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| Themen: |
B5S3K2V0G8 |
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| Anmerkungen: |
Date Completed 24.06.2021 Date Revised 04.12.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1182/bloodadvances.2021004904 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM326853804 |
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| 100 | 1 | |a Tølbøll Sørensen, Anne Louise |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A case of thrombocytopenia and multiple thromboses after vaccination with ChAdOx1 nCoV-19 against SARS-CoV-2 |
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| 520 | |a © 2021 by The American Society of Hematology. | ||
| 520 | |a Recently, reports of severe thromboses, thrombocytopenia, and hemorrhage in persons vaccinated with the chimpanzee adenovirus-vectored vaccine (ChAdOx1 nCoV-19, AZD1222, Vaxzevria; Oxford/AstraZeneca) against severe acute respiratory syndrome coronavirus 2 have emerged. We describe an otherwise healthy 30-year-old woman who developed thrombocytopenia, ecchymosis, portal vein thrombosis, and cerebral venous sinus thrombosis the second week after she received the ChAdOx1 nCoV-19 vaccine. Extensive diagnostic workup for thrombosis predispositions showed heterozygosity for the prothrombin mutation, but no evidence of myeloproliferative neoplasia or infectious or autoimmune diseases. Her only temporary risk factor was long-term use of oral contraceptive pills (OCPs). Although both the prothrombin mutation and use of OCPs predispose to portal and cerebral vein thrombosis, the occurrence of multiple thromboses within a short time and the associated pattern of thrombocytopenia and consumption coagulopathy are highly unusual. A maximum 4T heparin-induced thrombocytopenia (HIT) score and a positive immunoassay for anti-platelet factor 4/heparin antibodies identified autoimmune HIT as a potential pathogenic mechanism. Although causality has not been established, our case emphasizes the importance of clinical awareness. Further studies of this potentially new clinical entity have suggested that it should be regarded as a vaccine-induced immune thrombotic thrombocytopenia | ||
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| 700 | 1 | |a Jensen, Tomas Ø |e verfasserin |4 aut | |
| 700 | 1 | |a Kolte, Lilian |e verfasserin |4 aut | |
| 700 | 1 | |a El Fassi, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Hillingsø, Jens |e verfasserin |4 aut | |
| 700 | 1 | |a Radziwon-Balicka, Aneta |e verfasserin |4 aut | |
| 700 | 1 | |a Soyka, Robert Sebastian |e verfasserin |4 aut | |
| 700 | 1 | |a Hansen, Klaus |e verfasserin |4 aut | |
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| 700 | 1 | |a Stensballe, Jakob |e verfasserin |4 aut | |
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