Refractory vaccine-induced immune thrombotic thrombocytopenia (VITT) managed with delayed therapeutic plasma exchange (TPE).


Journal

Journal of clinical apheresis
ISSN: 1098-1101
Titre abrégé: J Clin Apher
Pays: United States
ID NLM: 8216305

Informations de publication

Date de publication:
Feb 2022
Historique:
revised: 08 10 2021
received: 25 07 2021
accepted: 09 10 2021
pubmed: 22 10 2021
medline: 9 2 2022
entrez: 21 10 2021
Statut: ppublish

Résumé

Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a newly described hematologic disorder, which presents as acute thrombocytopenia and thrombosis after administration of the ChAdOx1 nCov-19 (AstraZeneca) and Ad26.COV2.S (Johnson & Johnson) adenovirus-based vaccines against COVID-19. Due to positive assays for antibodies against platelet factor 4 (PF4), VITT is managed similarly to autoimmune heparin-induced thrombocytopenia (HIT) with intravenous immunoglobulin (IVIG) and non-heparin anticoagulation. We describe a case of VITT in a 50-year-old man with antecedent alcoholic cirrhosis who presented with platelets of 7 × 10

Identifiants

pubmed: 34672380
doi: 10.1002/jca.21945
doi:

Substances chimiques

Ad26COVS1 JT2NS6183B
PF4 protein, human 0
Platelet Factor 4 37270-94-3

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

117-121

Informations de copyright

© 2021 Wiley Periodicals LLC.

Références

Scully M, Singh D, Lown R, et al. Pathologic antibodies to platelet factor 4 after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384(23):2202-2211. doi:10.1056/NEJMoa2105385
Greinacher A, Thiele T, Warkentin TE, Weisser K, Kyrle PA, Eichinger S. Thrombotic thrombocytopenia after ChAdOx1 nCov-19 vaccination. N Engl J Med. 2021;384(22):2092-2101. doi:10.1056/NEJMoa2104840
Schultz NH, Sørvoll IH, Michelsen AE, et al. Thrombosis and thrombocytopenia after ChAdOx1 nCoV-19 vaccination. N Engl J Med. 2021;384(22):2124-2130. doi:10.1056/NEJMoa2104882
Muir K-L, Kallam A, Koepsell SA, Gundabolu K. Thrombotic thrombocytopenia after Ad26.COV2.S vaccination. N Engl J Med. 2021;384(20):1964-1965. doi:10.1056/NEJMc2105869
See I, Su JR, Lale A, et al. US case reports of cerebral venous sinus thrombosis with thrombocytopenia after Ad26.COV2.S vaccination, March 2 to April 21, 2021. JAMA. 2021;325(24):2448. doi:10.1001/jama.2021.7517
Sangli S, Virani A, Cheronis N, et al. Thrombosis with thrombocytopenia after the messenger RNA-1273 vaccine. Ann Intern Med. 2021;174(10):1480-1482. doi:10.7326/L21-0244
Pavord S, Scully M, Hunt BJ, et al. Clinical features of vaccine-induced immune thrombocytopenia and thrombosis. N Engl J Med. 2021. doi:10.1056/nejmoa2109908
Nazy I, Sachs UJ, Arnold DM, et al. Recommendations for the clinical and laboratory diagnosis of VITT against COVID-19: communication from the ISTH SSC subcommittee on platelet immunology. J Thromb Haemost. 2021;19(6):1585-1588. doi:10.1111/jth.15341
International Society on Thrombosis and Haemostasis (ISTH). The ISTH Releases Interim Guidance on Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT). International Society on Thrombosis and Haemostasis. 2021 [cited 2021Jul1]. Available from: https://www.isth.org/news/561406/The-ISTH-Releases-Interim-Guidance-on-Vaccine-Induced-Immune-Thrombotic-Thrombocytopenia-VITT-.htm.
British Society for Haematology. Guidance produced by the Expert Haematology Panel (EHP) focused on Vaccine Induced Thrombosis and Thrombocytopenia (VITT). British Society for Haematology. 2021 [cited 2021Jul1]. Available from: https://b-s-h.org.uk/about-us/news/guidance-produced-by-the-expert-haematology-panel-ehp-focussed-on-vaccine-induced-thrombosis-and-thrombocytopenia-vitt/.
Irani M, Siegal E, Jella A, Aster R, Padmanabhan A. Use of intravenous immunoglobulin G to treat spontaneous heparin-induced thrombocytopenia. Transfusion. 2018;59(3):931-934. doi:10.1111/trf.15105
Bourguignon A, Arnold DM, Warkentin TE, et al. Adjunct immune globulin for vaccine-induced IMMUNE thrombotic thrombocytopenia. N Engl J Med. 2021;385(8):720-728. doi:10.1056/nejmoa2107051
Onuoha C, Barton KD, Wong ECC, et al. Therapeutic plasma exchange and intravenous immune globulin in the treatment of heparin-induced thrombocytopenia: a systematic review. Transfusion. 2020;60(11):2714-2736. doi:10.1111/trf.16018
Oldenburg J, Klamroth R, Langer F, et al. Diagnosis and management of vaccine-related thrombosis following AstraZeneca COVID-19 vaccination: guidance statement from the GTH. Hamostaseologie. 2021;41:184-189. doi:10.1055/a-1469-7481
Favaloro EJ. Laboratory testing for suspected COVID-19 vaccine-induced (immune) thrombotic thrombocytopenia. Int J Lab Hematol. 2021 Aug;43(4):559-570. doi:10.1111/ijlh.13629
Patriquin CJ, Laroche V, Selby R, et al. Therapeutic plasma exchange in vaccine-induced immune thrombotic thrombocytopenia. N Engl J Med. 2021;385(9):857-859. doi:10.1056/nejmc2109465
Rock G, Weber V, Stegmayr B. Therapeutic plasma exchange (TPE) as a plausible rescue therapy in severe vaccine-induced immune thrombotic thrombocytopenia. Transfus Apher Sci. 2021;60(4):103174. doi:10.1016/j.transci.2021.103174
Al-Mayhani T, Saber S, Stubbs MJ, et al. Ischaemic stroke as a presenting feature of ChAdOx1 nCoV-19 vaccine-induced immune thrombotic thrombocytopenia. J Neurol Neurosurg Psychiatry. 2021;92(11):1247-1248. doi:10.1136/jnnp-2021-326984

Auteurs

Ajay Major (A)

Department of Medicine, Section of Hematology/Oncology, The University of Chicago, Chicago, Illinois, USA.

Timothy Carll (T)

Department of Pathology, The University of Chicago, Chicago, Illinois, USA.

Clarence W Chan (CW)

Department of Pathology, The University of Chicago, Chicago, Illinois, USA.

Chancey Christenson (C)

Department of Pathology, The University of Chicago, Chicago, Illinois, USA.

Fatima Aldarweesh (F)

Department of Pathology, The University of Chicago, Chicago, Illinois, USA.

Geoffrey D Wool (GD)

Department of Pathology, The University of Chicago, Chicago, Illinois, USA.

Kenneth S Cohen (KS)

Department of Medicine, Section of Hematology/Oncology, The University of Chicago, Chicago, Illinois, USA.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH