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Acta Haematol: Successful treatment of vaccine-induced immune thrombotic thrombocytopenia in a 26-year-old female patient

 Last Update: 2022-01-21
 Source: Internet
 Author: User

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Vaccine-induced immune thrombotic thrombocytopenia (VITT) has been reported following vaccination with ChAdOx2 nCov-19 (AstraZeneca) and Ad26.
COV2.
S (Johnson & Johnson/Janssen)
.

However, little is known about the optimal treatment regimen for patients suspected of VITT

Vaccine-induced immune thrombotic thrombocytopenia (VITT) has been reported following vaccination with ChAdOx2 nCov-19 (AstraZeneca) and Ad26.

Case: Case:

A 26-year-old female patient received the first dose of ChAdOx1nCov-19 on March 26, 2021
.

The patient had been taking progestin-only oral contraceptives (desogestrel 75 μg) for 1 year and was obese (BMI 31 kg/m ² ) but never smoked

A 26-year-old female patient received the first dose of ChAdOx1nCov-19 on March 26, 2021

Nine days after vaccination, the patient had pain and swelling in the right calf

Figure: D-dimer levels and platelet counts under treatment
.

Following high-dose IVIG (1 g/kg on days 1 and 2) and intravenous argatroban, D-dimer levels decreased slowly (red line) and platelet counts increased (blue line)

Figure: D-dimer levels and platelet counts under treatment

There were no clinical symptoms of cerebral venous thrombosis (CVT) or pulmonary embolism at this time

Venous ultrasonography on hospital day 9 (day 17 post-vaccination) revealed residual thrombotic material in the right peroneal vein

The investigators recommend immediate IVIG and parental anticoagulation with a non-heparin anticoagulant (eg, argatroban iv) in all VTE patients with high suspicion of VITT

Original source:

Kemper M, Lenz G, Mesters R, M: Successful Treatment of Vaccine-Induced Immune Thrombotic Thrombocytopenia in a 26-Year-Old Female Patient.

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