A case of Vaccine-Induced Thrombotic Thrombocytopenia (VITT) with thrombosis of the superior mesenteric artery after ChAdOx1 nCov-19 COVID-19 Vaccine
Open Access
- 20 December 2021
- journal article
- research article
- Published by PAGEPress Publications in Emergency Care Journal
- Vol. 17 (4)
- https://doi.org/10.4081/ecj.2021.10032
Abstract
We describe the case of a 64 years-old woman admitted to the Emergency Department of the ASST-Spedali Civili of Brescia with fever and gastrointestinal symptoms 10 days after the first dose of ChAdOx1 nCov-19 vaccine. Laboratory investigations showed severe thrombocytopenia and high D-dimer, while an abdominal CT scan reported a partially occluding thrombosis of the superior mesenteric artery. Following treatment with fondaparinux, immunoglobulins and high dosage steroid therapy, we observed a rapid improvement of patient’s conditions. An ELISA assay showed the presence of antibodies against heparin PF4-complex. Subsequent abdominal CT-scan showed the superior mesenteric artery thrombosis resolution, and the patient was finally discharged after 12 days of hospitalization. Several reports pointed to the venous system as the main district affected by Vaccine-Induced Thrombotic Thrombocytopenia (VITT), while a peculiar feature of this report is the involvement of the mesenteric arterial system. Further investigation of VITT’s pathophysiological mechanisms is mandatory to develop preventive strategies and effective treatments.Keywords
This publication has 19 references indexed in Scilit:
- Pathologic Antibodies to Platelet Factor 4 after ChAdOx1 nCoV-19 VaccinationThe New England Journal of Medicine, 2021
- Hypotheses behind the very rare cases of thrombosis with thrombocytopenia syndrome after SARS-CoV-2 vaccinationThrombosis Research, 2021
- COVID‐19 vaccine‐associated immune thrombosis and thrombocytopenia (VITT): Diagnostic and therapeutic recommendations for a new syndromeEuropean Journal of Haematology, 2021
- Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: population based cohort studyBMJ, 2021
- Vaccine‐induced immune thrombotic thrombocytopenia: Consider IVIG batch in the treatmentJournal of Thrombosis and Haemostasis, 2021
- Thrombosis after covid-19 vaccinationBMJ, 2021
- Diagnosis and Management of Vaccine-Related Thrombosis following AstraZeneca COVID-19 Vaccination: Guidance Statement from the GTHHämostaseologie, 2021
- Mini-Review Discussing the Reliability and Efficiency of COVID-19 VaccinesDiagnostics, 2021
- Treatment of COVID-19: a review of current and prospective pharmacotherapiesBritish Journal of Hospital Medicine, 2021
- A Review of the Progress and Challenges of Developing a Vaccine for COVID-19Frontiers in Immunology, 2020