tetano
Editor, Senior Moderator
Asian Pac J Allergy Immunol
. 2022 Mar 12.
doi: 10.12932/AP-101121-1271. Online ahead of print.
Thrombosis with thrombocytopenia after the second ChAdOx1 nCoV-19 vaccination: A possible immunological mechanism independent of anti-platelet factor 4 antibody
Noppacharn Uaprasert[SUP] 1 2 [/SUP], Ponlapat Rojnuckarin[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a distinctive syndrome characterized by unusual site thrombosis accompanied by thrombocytopenia following adenoviral vector vaccines against severe acute respiratory syndrome coronavirus 2. Platelet-activating anti-platelet factor 4-dependent antibodies (anti-PF4 Abs) have been identified as pathogenic antibodies in almost all patients.
Objective: We proposed an immunological mechanism of VITT independent of anti-PF4 Abs.
Methods: Case report.
Results: A 68-year-old Thai woman developed pulmonary embolism and deep vein thrombosis with thrombocytopenia one week after the second ChAdOx1 nCoV-19 vaccination with undetectable anti-PF4 Abs. The platelet count responded rapidly to intravenous immunoglobulin and steroids. Therefore, the high clinical suspicion is essential for early recognition and prompt management irrespective of anti-PF4 Ab results.
Conclusions: We hypothesize that platelet and endothelial activation following ChAdOx1 nCoV-19 vaccination may lead to generation of pathogenic antibodies which account for VITT independent of anti-PF4 Abs.
. 2022 Mar 12.
doi: 10.12932/AP-101121-1271. Online ahead of print.
Thrombosis with thrombocytopenia after the second ChAdOx1 nCoV-19 vaccination: A possible immunological mechanism independent of anti-platelet factor 4 antibody
Noppacharn Uaprasert[SUP] 1 2 [/SUP], Ponlapat Rojnuckarin[SUP] 1 2 [/SUP]
Affiliations
- PMID: 35278060
- DOI: 10.12932/AP-101121-1271
Abstract
Background: Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a distinctive syndrome characterized by unusual site thrombosis accompanied by thrombocytopenia following adenoviral vector vaccines against severe acute respiratory syndrome coronavirus 2. Platelet-activating anti-platelet factor 4-dependent antibodies (anti-PF4 Abs) have been identified as pathogenic antibodies in almost all patients.
Objective: We proposed an immunological mechanism of VITT independent of anti-PF4 Abs.
Methods: Case report.
Results: A 68-year-old Thai woman developed pulmonary embolism and deep vein thrombosis with thrombocytopenia one week after the second ChAdOx1 nCoV-19 vaccination with undetectable anti-PF4 Abs. The platelet count responded rapidly to intravenous immunoglobulin and steroids. Therefore, the high clinical suspicion is essential for early recognition and prompt management irrespective of anti-PF4 Ab results.
Conclusions: We hypothesize that platelet and endothelial activation following ChAdOx1 nCoV-19 vaccination may lead to generation of pathogenic antibodies which account for VITT independent of anti-PF4 Abs.