tetano
Editor, Senior Moderator
Res Pract Thromb Haemost
. 2021 Sep 14;5(6):e12596.
doi: 10.1002/rth2.12596. eCollection 2021 Aug.
Vaccine-induced immune thrombotic thrombocytopenia presenting with normal platelet count
David Page[SUP] 1 [/SUP], Nancy Zhu[SUP] 1 [/SUP], Daniel Sawler[SUP] 1 [/SUP], Hao Wei Sun[SUP] 1 [/SUP], Elona Turley[SUP] 2 3 [/SUP], Menaka Pai[SUP] 4 [/SUP], Cynthia Wu[SUP] 1 [/SUP]
Affiliations
Abstract
Adenoviral-vector based vaccines for coronavirus disease 2019 (COVID-19) have been linked with a thrombotic syndrome, vaccine-induced thrombotic thrombocytopenia (VITT). A key clinical question is whether VITT can be reliably ruled out by the absence of thrombocytopenia. We report on three patients who presented to our institute with this syndrome. Noteworthy in our presentations are two patients who presented for medical assessment of thrombotic symptoms with a normal platelet count, one preceding and one following a period of thrombocytopenia. Prompt diagnosis of VITT is critical to prevent rapid patient decline. We provide herein a new diagnostic algorithm that we believe will help optimally capture case presentations of VITT. These cases broaden and refine our understanding of the disease process and highlight to practitioners that VITT cannot be adequately ruled out by thrombocytopenia alone.
Keywords: COVID‐19; diagnosis; thrombocytopenia; thrombosis; vaccines.
. 2021 Sep 14;5(6):e12596.
doi: 10.1002/rth2.12596. eCollection 2021 Aug.
Vaccine-induced immune thrombotic thrombocytopenia presenting with normal platelet count
David Page[SUP] 1 [/SUP], Nancy Zhu[SUP] 1 [/SUP], Daniel Sawler[SUP] 1 [/SUP], Hao Wei Sun[SUP] 1 [/SUP], Elona Turley[SUP] 2 3 [/SUP], Menaka Pai[SUP] 4 [/SUP], Cynthia Wu[SUP] 1 [/SUP]
Affiliations
- PMID: 34532632
- PMCID: PMC8440941
- DOI: 10.1002/rth2.12596
Abstract
Adenoviral-vector based vaccines for coronavirus disease 2019 (COVID-19) have been linked with a thrombotic syndrome, vaccine-induced thrombotic thrombocytopenia (VITT). A key clinical question is whether VITT can be reliably ruled out by the absence of thrombocytopenia. We report on three patients who presented to our institute with this syndrome. Noteworthy in our presentations are two patients who presented for medical assessment of thrombotic symptoms with a normal platelet count, one preceding and one following a period of thrombocytopenia. Prompt diagnosis of VITT is critical to prevent rapid patient decline. We provide herein a new diagnostic algorithm that we believe will help optimally capture case presentations of VITT. These cases broaden and refine our understanding of the disease process and highlight to practitioners that VITT cannot be adequately ruled out by thrombocytopenia alone.
Keywords: COVID‐19; diagnosis; thrombocytopenia; thrombosis; vaccines.