期刊
JOURNAL OF THROMBOSIS AND HAEMOSTASIS
卷 19, 期 7, 页码 1819-1822出版社
ELSEVIER SCIENCE INC
DOI: 10.1111/jth.15346
关键词
COVID-19; ChAdOx1 vaccine; vaccine-induced prothrombotic immune thrombocytopenia; VIPIT; high-dose intravenous immunoglobulins
In cases of VIPIT following ChAdOx1 nCoV-19 vaccination, early initiation of treatment can effectively reduce the risk of thrombosis and lead to rapid improvement in the patient's health without thrombotic complications.
Cases of unusual thrombosis and thrombocytopenia after administration of the ChAdOx1 nCoV-19 vaccine (AstraZeneca) have been reported. The term vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) was coined to reflect this new phenomenon. In vitro experiments with VIPIT patient sera indicated that high-dose intravenous immunoglobulins (IVIG) competitively inhibit the platelet-activating properties of ChAdOx1 nCoV-19 vaccine induced antibodies. Here, we report a case of a 62-year-old woman who had received this vaccine and developed VIPIT. She visited the emergency ward because of petechiae and hematomas. In the laboratory work-up, thrombocytopenia, low fibrinogen, elevated D-dimer, and positivity in the platelet factor 4/heparin-enzyme-immunoassay were present. Signs and symptoms of thrombosis were absent. Upon immediate therapy with non-heparin anticoagulation, high-dose IVIG, and prednisolone, laboratory parameters steadily improved and the patient was discharged from hospital without thrombotic complications. We conclude that early initiation of VIPIT treatment results in a swift response without thrombotic complications.
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