Vaccine-induced thrombosis and thrombocytopenia (VITT) in Ireland: A review of cases and current practices

Swan, Dawn; Enright, Helen; Desmond, Ronan; Lê, Giao; Hassadi, Ezzat El; Hennessy, Brian; Lynott, Fiona; O’Keeffe, Denis; Crowley, Maeve P.; Smyth, Laura Dimmit; Perera, Kanthi; Jennings, Catherine; Áinle, Fionnuala Ní; Coll, Jillian; Ryan, Kevin M.; O’Donnell, James S.; Lavin, Michelle; O’Connell, Niamh M

doi:10.1016/j.tru.2021.100086

Cited by 5 publications

(2 citation statements)

References 42 publications

(58 reference statements)

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“…Given its close pathophysiologic similarities to heparininduced thrombocytopenia, most treatment recommendations have been established based on the extrapolation of data from heparin-induced thrombocytopenia. Intravenous immunoglobulin and anticoagulation with non-heparin-derived anticoagulants are the mainstays of treatment of VITT [7].…”

Section: Discussionmentioning

confidence: 99%

A Case of Vaccine-Induced Thrombocytopenic Thrombosis Manifesting as Cerebral Venous Thrombosis and Intracerebral Bleed

Bellamy¹,

Loor²

2023

Cureus

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Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but detrimental syndrome that has been most commonly reported after the administration of vaccination for the prevention of viral infections. VITT often presents with thrombosis at unusual sites such as cerebral venous sinuses, portal, splanchnic or hepatic veins, in association with thrombocytopenia and elevated anti-platelet factor 4 (aPF-4) antibodies. We describe the case of a young male patient who developed thrombocytopenia, cerebral sinus venous thrombosis, and intracerebral bleed 12 days after receiving the Ad26.COV2.S (Janssen/Johnson&Johnson) COVID-19 vaccine.

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Section: Discussionmentioning

confidence: 99%

A Case of Vaccine-Induced Thrombocytopenic Thrombosis Manifesting as Cerebral Venous Thrombosis and Intracerebral Bleed

Bellamy¹,

Loor²

2023

Cureus

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“…VITT presents clinically with thrombocytopenia and thrombosis [ 2 ]. Thrombocytopenia occurs in virtually all patients, with a median platelet count nadir of 30–40 × 10 9 /L [ 2 , 19 ]. Other laboratory tests that are characteristic of VITT are an elevated D-dimer (> 10 mg/L); a decreased or low-normal fibrinogen level; and a normal or mildly increased prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) [ 20 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

Unique features of vaccine-induced immune thrombotic thrombocytopenia; a new anti-platelet factor 4 antibody-mediated disorder

et al. 2022

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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.

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Vaccine-induced immune thrombotic thrombocytopenia: what do we know hitherto?

Roytenberg

Garcı́a-Sastre

2023

Front. Med.

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Vaccine-induced immune thrombotic thrombocytopenia (VITT), also known as thrombosis with thrombocytopenia syndrome, is a catastrophic and life-threatening reaction to coronavirus disease 2019 (COVID-19) vaccines, which occurs disproportionately in response to vaccination with non-replicating adenovirus vector (AV) vaccines. The mechanism of VITT is not well defined and it has not been resolved why cases of VITT are predominated by vaccination with AV vaccines. However, virtually all VITT patients have positive platelet-activating anti-platelet factor 4 (PF4) antibody titers. Subsequently, platelets are activated and depleted in an Fcγ-receptor IIa (FcγRIIa or CD32a)-dependent manner, but it is not clear why or how the anti-PF4 response is mounted. This review describes the pathogenesis of VITT and provides insight into possible mechanisms that prompt the formation of a PF4/polyanion complex, which drives VITT pathology, as an amalgam of current experimental data or hypotheses.

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Vaccine-induced thrombosis and thrombocytopenia (VITT) in Ireland: A review of cases and current practices

Cited by 5 publications

References 42 publications

A Case of Vaccine-Induced Thrombocytopenic Thrombosis Manifesting as Cerebral Venous Thrombosis and Intracerebral Bleed

A Case of Vaccine-Induced Thrombocytopenic Thrombosis Manifesting as Cerebral Venous Thrombosis and Intracerebral Bleed

Unique features of vaccine-induced immune thrombotic thrombocytopenia; a new anti-platelet factor 4 antibody-mediated disorder

Vaccine-induced immune thrombotic thrombocytopenia: what do we know hitherto?

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