Heparin-Induced Thrombotic Thrombocytopenia (HITT) and Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT): Similar but Different

Favaloro, Emmanuel J.; Pasalic, Leonardo

doi:10.1007/978-1-0716-3175-1_26

Cited by 4 publications

(3 citation statements)

References 42 publications

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“…Also, several of the leading COVID-19-related papers in the top listings (►Tables 3 and 4) were not really on COVID-19, but rather on VITT, representing a rare but serious adverse event in some people immunized against COVID-19, most notably using adenovirus-based vaccines. 55,56 In total, considering the top 25 papers in the "Free to download" most popular (►Table 3) and the top 25 papers in the general category most popular (►Table 4), the most popular issues were: Ã Professor Iba has declined the cash prize.…”

Section: General Categorymentioning

confidence: 99%

2024 Eberhard F. Mammen Award Announcements: Part I—Most Popular Articles

Favaloro

2024

Semin Thromb Hemost

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Welcome to the latest of our Eberhard F. Mammen award announcements. As noted in previous editorials (►Table 1), Thieme, the publisher of Seminars in Thrombosis & Hemostasis (STH), has created the "Eberhard F. Mammen Excellence in Thrombosis and Hemostasis Awards" in honor of Eberhard Mammen (►Fig. 1), and in recognition of his contribution to this field and to the journal that he both founded and steered for over three decades. These awards began in 2009, under two categories, "Most Popular Article Awards" and "Young Investigator Awards." Accordingly, 2024 represents 16 years of award presentations (►Table 1). Current details and conditions of the award can be summarized as:➢ Most Popular Article Awards: awarded to the authors of the most popular articles published in STH in the preceding 2 years as captured in the preceding year.The awards are determined by the Editor in Chief on the basis of user statistics from the publisher Thieme e-Journals. Prefaces, Errata, Letters to the Editor, Editorials, Commentaries, and previous award-winning articles are excluded from further consideration of these awards, which currently comprise two categories-one for "Free Access" articles, and another for a "General Category." There are two major cash prizes of US$1,000 for each category. In addition, winners of the "General Category" awards are granted "Free Access" status for these articles thereafter.

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Section: General Categorymentioning

confidence: 99%

2024 Eberhard F. Mammen Award Announcements: Part I—Most Popular Articles

Favaloro

2024

Semin Thromb Hemost

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“…Little did we know then that the COVID-19 pandemic and our attempts to circumvent infections or severe disease using vaccines would lead to a rare event that came to be known as VITT (for vaccine-induced [immune] thrombotic thrombocytopenia), with a pathophysiological basis similar to HITT, with development of anti-PF4 antibodies, albeit this time unrelated to heparin use. 120 121 The COVID-19 pandemic seemed for a time to morph into a “VITT-pandemic,” although in reality this adverse event of vaccine use was rare by HIT standards. Whereas HIT can occur in some 1 to 3% of exposures to unfractionated heparin, VITT only occurs in around 1/50,000 to 1/100,000 doses of vaccine, with only adenovirus-based vaccines consistently confirmed as being associated with VITT.…”

Section: Some Personal Highlights During My 40 Years At Westmeadmentioning

confidence: 99%

Evolution of Hemostasis Testing: A Personal Reflection Covering over 40 Years of History*

Favaloro

2023

Semin Thromb Hemost

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There is no certainty in change, other than change is certain. As Seminars in Thrombosis and Hemostasis celebrates 50 years of publication, I felt it appropriate to reflect on my own 40-year plus scientific career. My career in the thrombosis and hemostasis field did not start until 1987, but the subsequent 35 years reflected a period of significant change in associated disease diagnostics. I started in the Westmead Hospital “coagulation laboratory” when staff were still performing manual clotting tests, using stopwatches, pipettes, test tubes, and a water bath, which we transported to the hospital outpatient department to run our weekly warfarin clinic. Several hemostasis instruments have come and gone, including the Coag-A-Mate X2, the ACL-300R, the MDA-180, the BCS XP, and several StaR Evolution analyzers. Some instruments remain, including the PFA-100, PFA-200, the AggRAM, the CS-5100, an AcuStar, a Hydrasys gel system, and two ACL-TOP 750s. We still have a water bath, but this is primarily used to defrost frozen samples, and manual clotting tests are only used to teach visiting medical students. We have migrated across several methodologies in the 45-year history of the local laboratory. Laurel gel rockets, used for several assays in the 1980s, were replaced with enzyme-linked immunosorbent assay assays and most assays were eventually placed on automated instruments. Radio-isotopic assays, used in the 1980s, were replaced by an alternate safer method or else abandoned. Test numbers have increased markedly over time. The approximately 31,000 hemostasis assays performed at the Westmead-based laboratory in 1983 had become approximately 200,000 in 2022, a sixfold increase. Some 90,000 prothrombin times and activated partial thromboplastic times are now performed at this laboratory per year. Thrombophilia assays were added to the test repertoires over time, as were the tests to measure several anticoagulant drugs, most recently the direct oral anticoagulants. I hope my personal history, reflecting on the changes in hemostasis testing over my career to date in the field, is found to be of interest to the readership, and I hope they forgive any inaccuracies I have introduced in this reflection of the past.

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“…While similarities between HIT and VITT are confined to their PF4-mediated immunological responses, differences between them stand out and are relevant for diagnosis and treatment [21]. Classic HIT is dependent on heparin, where PF4-heparin complexes induce an immune response resulting in high titer anti-PF4-heparin antibodies.…”

Section: Similarities and Differences Between Vitt Hit And Its Variantsmentioning

confidence: 99%

Vaccine-Induced Immune Thrombocytopenia and Thrombosis (VITT)—Insights from Clinical Cases, In Vitro Studies and Murine Models

Dabbiru,

Müller,

Schönborn

et al. 2023

JCM

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An effective worldwide vaccination campaign started and is still being carried out in the face of the coronavirus disease 2019 (COVID-19) pandemic. While vaccines are great tools to confront the pandemic, predominantly adenoviral vector-based vaccines can cause a rare severe adverse effect, termed vaccine-induced immune thrombocytopenia and thrombosis (VITT), in about 1 in 100,000 vaccinated individuals. VITT is diagnosed 5–30 days post-vaccination and clinically characterized by thrombocytopenia, strongly elevated D-dimer levels, platelet-activating anti-platelet factor 4 (PF4) antibodies and thrombosis, especially at atypical sites such as the cerebral venous sinus and/or splanchnic veins. There are striking similarities between heparin-induced thrombocytopenia (HIT) and VITT. Both are caused by anti-PF4 antibodies, causing platelet and leukocyte activation which results in massive thrombo-inflammation. However, it is still to be determined why PF4 becomes immunogenic in VITT and which constituent of the vaccine triggers the immune response. As VITT-like syndromes are increasingly reported in patients shortly after viral infections, direct virus-PF4 interactions might be most relevant. Here we summarize the current information and hypotheses on the pathogenesis of VITT and address in vivo models, especially murine models for further studies on VITT.

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Heparin-Induced Thrombotic Thrombocytopenia (HITT) and Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT): Similar but Different

Cited by 4 publications

References 42 publications

2024 Eberhard F. Mammen Award Announcements: Part I—Most Popular Articles

2024 Eberhard F. Mammen Award Announcements: Part I—Most Popular Articles

Evolution of Hemostasis Testing: A Personal Reflection Covering over 40 Years of History*

Vaccine-Induced Immune Thrombocytopenia and Thrombosis (VITT)—Insights from Clinical Cases, In Vitro Studies and Murine Models

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