Clinical course, management, and platelet activity assessment of splanchnic VITT: A case report

Corica, Bernadette; Cacciani, Antonella; Cangemi, Roberto; Visentini, Marcella; Recchia, Fabrizio; Grillo, Rosalba; Vano, M; Sperduti, Nicolò; Cincione, Alessandro; Buoninfante, Giovanni; Pulcinelli, Fabio; Chistolini, Antonio; Santis, Adriano De; Flego, Davide; Romiti, Giulio Francesco; Basili, Stefania; Stefanini, Lucia

doi:10.1016/j.thromres.2021.10.008

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…( 42 ) This is also the case for most VITT patients( 43 , 44 , 45 , 46 , 47 ), although no comprehensive analysis of platelet recovery has yet been performed in a large cohort. One must differentiate between those VITT patients who show refractory thrombocytopenia or a relapse of thrombocytopenia within or immediately after the acute episode( 48 , 49 ) (persisting VITT), and those who show decreasing platelet counts weeks or months after full recovery of the acute episode( 50 ) (recurrent VITT). For each scenario a representative patient example is described below.…”

Section: Clinical Follow-up Of Vitt Patientsmentioning

confidence: 99%

“…Corica et al( 49 ) described a VITT patient with severe abdominal pain with onset 8 days after receiving ChAdOx1 nCoV-19, computed tomography revealed portal vein thrombosis, with partial thrombosis of the superior mesenteric vein. Laboratory results showed thrombocytopenia (15×10 9 /L) and elevated D-Dimers (4.3 mg/L).…”

Section: Clinical Follow-up Of Vitt Patientsmentioning

confidence: 99%

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Longitudinal Aspects of VITT

Schönborn

Greinacher

2022

Seminars in Hematology

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Section: Clinical Follow-up Of Vitt Patientsmentioning

confidence: 99%

Section: Clinical Follow-up Of Vitt Patientsmentioning

confidence: 99%

Longitudinal Aspects of VITT

Schönborn

Greinacher

2022

Seminars in Hematology

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“…COV2.S (Johnson & Johnson/Janssen) have been linked to rare cases of vaccine-induced immune thrombotic thrombocytopenia (VITT). [44][45][46][47][48][49][50] Rare cases of immune thrombocytopenia (ITP) have also been reported following the mRNA COVID-19 vaccines and other anti-viral vaccines, but proof linking vaccines to de novo autoimmune disorders are lacking. [51][52][53] The frequency of these side effects is extremely low and the benefits of the vaccines in saving lives far outweighs the risk of thrombocytopenia or thrombosis in the general population.…”

Section: Discussionmentioning

confidence: 99%

“…In the last few months, the adenoviral vector‐based COVID‐19 vaccines, ChAdOx1nCoV‐19 (AstraZeneca/COVISHIELD) and Ad26.COV2.S (Johnson & Johnson/Janssen) have been linked to rare cases of vaccine‐induced immune thrombotic thrombocytopenia (VITT) 44‐50 . Rare cases of immune thrombocytopenia (ITP) have also been reported following the mRNA COVID‐19 vaccines and other anti‐viral vaccines, but proof linking vaccines to de novo autoimmune disorders are lacking 51‐53 .…”

Section: Discussionmentioning

confidence: 99%

Platelet and immune signature associated with a rapid response to the BNT162b2 mRNA COVID‐19 vaccine

Flego

Cesaroni

Romiti

et al. 2022

Journal of Thrombosis and Haemostasis

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Background A rapid immune response is critical to ensure effective protection against COVID‐19. Platelets are first‐line sentinels of the vascular system able to rapidly alert and stimulate the immune system. However, their role in the immune response to vaccines is not known. Objective To identify features of the platelet‐immune crosstalk that would provide an early readout of vaccine efficacy in adults who received the mRNA‐based COVID‐19 vaccine (BNT162b2). Methods We prospectively enrolled 11 young healthy volunteers (54% females, median age: 28 years) who received two doses of BNT162b2, 21 days apart, and we studied their platelet and immune response before and after each dose of the vaccine (3 and 10 ± 2 days post‐injection), in relation to the kinetics of the humoral response. Results Participants achieving an effective level of neutralizing antibodies before the second dose of the vaccine (fast responders) had a higher leukocyte count, mounted a rapid cytokine response that incremented further after the second dose, and an elevated platelet turnover that ensured platelet count stability. Their circulating platelets were not more reactive but expressed lower surface levels of the immunoreceptor tyrosine‐based inhibitory motif (ITIM)‐coupled receptor CD31 (PECAM‐1) compared to slow responders, and formed specific platelet‐leukocyte aggregates, with B cells, just 3 days after the first dose, and with non‐classical monocytes and eosinophils. Conclusion We identified features of the platelet‐immune crosstalk that are associated with the development of a rapid humoral response to an mRNA‐based vaccine (BNT162b2) and that could be exploited as early biomarkers of vaccine efficacy.

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Azd-1222

2022

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Clinical course, management, and platelet activity assessment of splanchnic VITT: A case report

Cited by 4 publications

References 18 publications

Longitudinal Aspects of VITT

Longitudinal Aspects of VITT

Platelet and immune signature associated with a rapid response to the BNT162b2 mRNA COVID‐19 vaccine

Azd-1222

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