Letter
Medicine, General & Internal
Christopher J. Patriquin, Vincent Laroche, Rita Selby, Jacob Pendergrast, David Barth, Benoit Cote, Nathalie Gagnon, Guillaume Roberge, Marc Carrier, Lana A. Castellucci, Dimitrios Scarvelis, Johnathan P. Mack
Summary: Therapeutic plasma exchange was effective in treating refractory VITT in three patients, who showed poor response to initial therapy with anticoagulants and intravenous immune globulin. Their conditions improved and they were discharged from the hospital after the treatment.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Correction
Medicine, General & Internal
Douglas B. Cines, James B. Bussel
Summary: The Covid-19 pandemic led to the rapid development of highly effective vaccines, with over 400 million people vaccinated so far and a remarkably low risk of serious adverse reactions.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Review
Critical Care Medicine
Toshiaki Iba, Jerrold H. Levy, Theodore E. Warkentin
Summary: Vaccine-induced immune thrombotic thrombocytopenia is an unexpected consequence of the COVID-19 pandemic. This study reviewed the pathogenesis, clinical presentation, diagnosis, and treatment of this rare side effect. Vaccine-induced immune thrombotic thrombocytopenia presents as unusual thromboses with severe thrombocytopenia, and early recognition and treatment are crucial.
CRITICAL CARE MEDICINE
(2022)
Editorial Material
Clinical Neurology
James E. Siegler, Piers Klein, Shadi Yaghi, Nicholas Vigilante, Mohamad Abdalkader, Jonathan M. Coutinho, Feras Abdul Khalek, Thanh N. Nguyen
Summary: In the spring of 2021, rare cases of venous thrombosis linked to ChAdOx1 and Ad26.COV2.S adenovirus-based coronavirus vaccines led to temporary suspensions in some countries. These events were associated with thrombocytopenia and anti-PF4 antibodies, resulting in vaccine-induced immune thrombotic thrombocytopenia.
Article
Hematology
Linda Schoenborn, Thomas Thiele, Lars Kaderali, Albrecht Guenther, Till Hoffmann, Sabrina Edigna Seck, Kathleen Selleng, Andreas Greinacher
Summary: In an observational study on vaccine-induced thrombotic thrombocytopenia (VITT), it was found that the platelet-activating antibodies in most patients are transient, and it is safe for VITT patients to receive a second dose of COVID-19 mRNA vaccine.
Article
Immunology
Tzu-Chien Lin, Pei-An Fu, Ya-Ting Hsu, Tsai-Yun Chen
Summary: This is a case report of Vaccine-induced immune thrombotic thrombocytopenia (VITT) following BNT162b2 (Pfizer-BioNTech) vaccine. A healthy 28-year-old man developed hemoptysis, bilateral leg pain, and headaches three weeks after his third dose of the COVID-19 vaccine. Further investigations revealed pulmonary embolisms, cerebral sinus, and deep iliac venous thrombosis. The diagnosis of VITT was confirmed by positive PF4 antibody assay. The patient responded well to intravenous immunoglobulins (IVIGs) and his symptoms are now under control with anticoagulant therapy. This case suggests that VITT can occur with mRNA-based vaccines like BNT162b2, and not just with adenoviral vector vaccines.
Article
Medicine, General & Internal
Alex Bourguignon, Donald M. Arnold, Theodore E. Warkentin, James W. Smith, Tania Pannu, Jeffrey M. Shrum, Zainab A. A. Al Maqrashi, Anjali Shroff, Marie-Claude Lessard, Normand Blais, John G. Kelton, Ishac Nazy
Summary: The use of high-dose IVIG plus anticoagulation is recommended for the treatment of VITT, a rare side effect of adenoviral vector vaccines against Covid-19. Response to IVIG therapy in VITT patients showed reduced platelet activation and improvement in symptoms.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Article
Immunology
Albrecht Guenther, Dirk Braemer, Mathias W. Pletz, Thomas Kamradt, Sabine Baumgart, Thomas E. Mayer, Michael Baier, Angelina Autsch, Christian Mawrin, Linda Schoenborn, Andreas Greinacher, Thomas Thiele
Summary: This study reported a VITT patient with an extremely severe condition, showing high titers of PF4-IgG antibodies, and described the treatment process and outcomes. Plasma exchange, immunoadsorption, and/or immunosuppressive treatment may be considered in such cases to reduce the high levels of anti-PF4-IgG.
Article
Medicine, General & Internal
Alex Bourguignon, Donald M. Arnold, Theodore E. Warkentin, James W. Smith, Tania Pannu, Jeffrey M. Shrum, Zainab A. A. Al Maqrashi, Anjali Shroff, Marie-Claude Lessard, Normand Blais, John G. Kelton, Ishac Nazy
Summary: High-dose intravenous immune globulin (IVIG) combined with anticoagulation is recommended for the treatment of vaccine-induced immune thrombotic thrombocytopenia (VITT), showing a good response in reducing antibody-induced platelet activation, particularly in cases of VITT induced by ChAdOx1 nCoV-19 vaccine.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Letter
Medicine, General & Internal
Caroline Vayne, Jerome Rollin, Yves Gruel, Claire Pouplard, Hubert Galinat, Olivier Huet, Vincent Memier, Thomas Geeraerts, Raphael Marlu, Gilles Pernod, Guillaume Mourey, Alexandra Fournel, Charlotte Cordonnier, Sophie Susen
Summary: VITT, a rare vaccine-induced disorder, may not be detected by rapid assays for anti-PF4 antibodies used to diagnose HIT. The PF4-serotonin release assay is effective in detecting IgG antibodies to PF4-PVS associated with VITT.
NEW ENGLAND JOURNAL OF MEDICINE
(2021)
Review
Hematology
Yumei Liu, Zonghong Shao, Huaquan Wang
Summary: Vaccine-induced immune thrombotic thrombocytopenia (VITT), a rare but severe complication after adenoviral vector vaccines, has attracted global attention. Its pathogenesis is similar to heparin-induced thrombocytopenia (HIT), and it has a high mortality rate.
THROMBOSIS RESEARCH
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Priya Rogers, Ieuan Walker, Jason Yeung, Abeera Khan, Anmol Gangi, Behnaz Mobashwera, Robert Ayto, Ali Shah, Joannes Hermans, Andrew Murchison, Matthew Benger, Sean Apap Mangion, Puja R. Mehta, Laszlo Sztriha, Simrit Ghatorae, Brian Craven, Marie Scully, Timothy Bray, Margaret Hall-Craggs, Conrad von Stempel
Summary: This study investigated the frequency and location of thrombus in each vascular system in patients with vaccine-induced immune thrombotic thrombocytopenia (VITT). The study found that patients with VITT are likely to have multiple thrombus sites, with cerebral venous sinus thrombosis being the most common. The use of contrast-enhanced CT can help identify occult thrombosis.
Article
Hematology
Maria V. V. Selvadurai, Emmanuel J. J. Favaloro, Vivien M. M. Chen
Summary: Heparin-induced thrombocytopenia (HIT) and vaccine-induced immune thrombotic thrombocytopenia (VITT) are rare immune-mediated conditions with high morbidity and mortality rates. HIT is a known reaction to heparin, while VITT is a new syndrome associated with coronavirus disease 2019 vaccines. Both conditions exhibit paradoxical thrombosis despite low platelet count, and involve platelet-activating antibodies to platelet factor 4. This review discusses the mechanisms contributing to thrombosis in both HIT and VITT, and explores their pathophysiological similarities and differences.
SEMINARS IN THROMBOSIS AND HEMOSTASIS
(2023)
Article
Immunology
Patricia Mouta Nunes de Oliveira, Daniela P. Mendes-de-Almeida, Victor Bertollo Gomes Porto, Catherine Crespo Cordeiro, Gabriellen Vitiello Teixeira, Renata Saraiva Pedro, Paulo Roberto Gomes Takey, Leticia Kegele Lignani, Janaina Reis Xavier, Vitor Cardoso Doria da Gamaa, Luiz Amorim Filho, Barbara Emoingt Furtado, Andre Santa Maria, Tiago Dahrug Barros, Livia Neves Waite Freitas, Taina dos Santos Pereira, Debora Lima Abreu, Michael Bernardes Ramos, Caroline Gabe, Donald Arnold, James William Smith, Ishac Nazy, Maria de Lourdes de Sousa Maia
Summary: This case series study describes vaccine-induced immune thrombotic thrombocytopenia (VITT) cases following COVID-19 vaccination in Brazil, including ChAdOx1 nCoV-19, Ad26.COV2.S, and BNT162b2 vaccines, and describes their clinical and laboratory characteristics. The study findings suggest that VITT is a very rare but serious adverse event following COVID-19 immunization.
Article
Cardiac & Cardiovascular Systems
Daniela P. Mendes-de-Almeida, Fernanda S. G. Kehdy, Remy Martins-Goncalves, Joanna Bokel, Eduarda Grinsztejn, Patricia Mouta Nunes de Oliveira, Maria de Lourdes de Sousa Maia, Brenda Hoagland, Sandra Wagner Cardoso, Beatriz Grinsztejn, Marilda M. Siqueira, Pedro Kurtz, Patricia T. Bozza, Cristiana C. Garcia
Summary: This article reports a case of a 56-year-old white man who developed vaccine-induced immune thrombocytopenia and thrombosis (VITT) after adenoviral vector vaccines, leading to death within 9 days of symptom onset. The patient presented with multiple thrombotic events and elevated inflammatory markers. Genetic investigation revealed the presence of numerous genetic variants possibly associated with VITT.
FRONTIERS IN CARDIOVASCULAR MEDICINE
(2023)