Unique features of vaccine-induced immune thrombotic thrombocytopenia; a new anti-platelet factor 4 antibody-mediated disorder.
PF4
Thrombocytopenia
Thrombosis
VITT
Journal
International journal of hematology
ISSN: 1865-3774
Titre abrégé: Int J Hematol
Pays: Japan
ID NLM: 9111627
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
received:
18
11
2022
accepted:
12
12
2022
revised:
02
12
2022
pubmed:
28
12
2022
medline:
3
3
2023
entrez:
27
12
2022
Statut:
ppublish
Résumé
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a highly prothrombotic disorder caused by anti-PF4 antibodies that activate platelets and neutrophils, leading to thrombosis. Heparin-induced thrombocytopenia (HIT) is a related anti-PF4 mediated disorder, with similar pathophysiology and clinical manifestations but different triggers (i.e., heparin vs adenoviral vector vaccine). Clinically, both HIT and VITT typically present with thrombocytopenia and thrombosis, although the risk of thrombosis is significantly higher in VITT, and the thromboses occur in unusual anatomical sites (e.g., cerebral venous sinus thrombosis and hepatic vein thrombosis). The diagnostic accuracy of available laboratory testing differs between HIT and VITT; for VITT, ELISAs have better specificity compared to HIT and platelet activation assays require the addition of PF4. Treatment of VITT and HIT is anticoagulation non-heparin anticoagulants; however, heparin may be considered for VITT if no other option is available.
Identifiants
pubmed: 36574172
doi: 10.1007/s12185-022-03516-4
pii: 10.1007/s12185-022-03516-4
pmc: PMC9793819
doi:
Substances chimiques
Anticoagulants
0
Heparin
9005-49-6
Immunologic Factors
0
Vaccines
0
PF4 protein, human
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
341-348Informations de copyright
© 2022. Japanese Society of Hematology.
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