Platelet count as an important prognostic factor for vaccine-induced immune thrombotic thrombocytopenia

Bang, Soo‐Mee; Na, Sang-Hoon; Kim, Ji Hyun; Kim, Seo Ree; Kim, Seong-Rim; Jang, Seongsoo

doi:10.5045/br.2021.2021126

Cited by 4 publications

(5 citation statements)

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“…A review of 44 VITT patients compared patients with favorable outcomes (recovery or full recovery) to those with unfavorable outcomes (death) and a cutoff nadir platelet count of 22,000/µL had significant value for predicting death. 13 In this case, the patient’s clinical course was improving despite severe thrombocytopenia below the suggested cutoff. The risk of death in VITT was independently related not only to the degree of thrombocytopenia but also to the presence of intracranial hemorrhage.…”

Section: Discussionmentioning

confidence: 72%

A Case Report of Thrombotic Thrombocytopenia After ChAdOx1 nCov-19 Vaccination and Heparin Use During Hemodialysis

et al. 2022

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Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare but life-threatening complication. VITT strongly mimics heparin-induced thrombocytopenia (HIT) and shares clinical features. Heparin is commonly used to prevent coagulation during hemodialysis. Therefore, nephrologists might encounter patients needing dialysis with a history of heparin exposure who developed thrombotic thrombocytopenia after vaccination. A 70-year-old male presented with acute kidney injury and altered mental status due to lithium intoxication. He needed consecutive hemodialysis using heparin. Deep vein thrombosis of left lower extremity and accompanying severe thrombocytopenia of 15,000/µL on 24 days after vaccination and at the same time, nine days after heparin use. Anti-platelet factor 4 antibody test was positive. Anticoagulation with apixaban and intravenous immunoglobulin (IVIG) infusion resolved swelling of his left calf and thrombocytopenia. There were no definitive diagnostic tools capable of differentiating between VITT and HIT in this patient. Although VITT and HIT share treatment with IVIG and non-heparin anticoagulation, distinguishing between VITT and HIT will make it possible to establish a follow-up vaccination plan in a person who has had a thrombocytopenic thrombotic event. Further research is needed to develop the tools to make a clear distinction between the clinical syndromes.

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Section: Discussionmentioning

confidence: 72%

A Case Report of Thrombotic Thrombocytopenia After ChAdOx1 nCov-19 Vaccination and Heparin Use During Hemodialysis

et al. 2022

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“…Estimated incidence of VITT by country4,8,10 in our cohort had concurrent cerebral sinus thrombosis and intracranial hemorrhage. All patients with intracranial hemorrhage died.…”

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confidence: 64%

“…To our knowledge, only four additional cases of VITT were reported in other Asian countries by the end of August 2021. Two cases of definite VITT were reported from South Korea 7 , 8 and Taiwan. 9 , 10 , 11 Most affected individuals were in their 30s, and most presented with clinical thrombosis and bleeding.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of VITT in South Korea is estimated at 1 in 6.4 million. 8 The incidence of VITT is estimated at 1 in 0.48 million in Taiwan according to the report from Taiwan’s Central Epidemic Command Center. 9 , 10 VITT occurred in 4 of 2.5 million doses given in Malaysia (Selvaratnam V., personal communication, September 8, 2021).…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of VITT is estimated at 1 in 3 million in Thailand. The incidence of VITT in South Korea is estimated at 1 in 6.4 million 8 . The incidence of VITT is estimated at 1 in 0.48 million in Taiwan according to the report from Taiwan’s Central Epidemic Command Center 9,10 .…”

Section: Discussionmentioning

confidence: 99%

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Vaccine‐induced immune thrombotic thrombocytopenia with ChAdOx1 nCoV‐19 is rare in Asia

Boonyawat

Angchaisuksiri

2022

Research and Practice in Thrombosis and Haemostasis

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Background Vaccination with ChAdOx1 n‐CoV‐19 is associated with a rare syndrome called vaccine‐induced immune thrombotic thrombocytopenia (VITT). VITT has been reported mainly in Western countries, whereas the report of VITT in Asians is sparse. Objectives To report a case series of VITT following ChAdOx1 n‐CoV‐19 in Thailand and to estimate the incidence of VITT among Asian countries. Methods We retrieved the number of VITT patients and the total inoculation doses from the database of the Thai Ministry of Public Health. We performed a literature search including published articles and gray literature to estimate the incidence of VITT. The incidences of VITT by countries and respective confidence intervals were calculated. Results By the end of August 2021, five VITT cases occurred after 15 million doses of ChAdOx1 n‐CoV‐19 in Thailand. The median age was 31 years, and 60% were women. The incidence of VITT is estimated at 1 in 3 million. In other Asian countries, only a few cases of VITT have been reported. The incidence of VITT is much lower than in those of Western countries, which is estimated at 1 in 100, 000. The fatality rate was 44% in this study. Conclusions Although the incidence of VITT in Asians is low, the mortality rate is substantially higher. We urge that public awareness of this syndrome be raised, as early recognition and appropriate treatment of this syndrome following ChAdOx1 n‐CoV‐19 are crucial to improve the outcome.

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Azd-1222

2022

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Platelet count as an important prognostic factor for vaccine-induced immune thrombotic thrombocytopenia

Abstract: count as an important prognostic factor for vaccine-induced immune thrombotic thrombocytopenia. Blood Res 2021.

Cited by 4 publications

References 6 publications

A Case Report of Thrombotic Thrombocytopenia After ChAdOx1 nCov-19 Vaccination and Heparin Use During Hemodialysis

A Case Report of Thrombotic Thrombocytopenia After ChAdOx1 nCov-19 Vaccination and Heparin Use During Hemodialysis

Vaccine‐induced immune thrombotic thrombocytopenia with ChAdOx1 nCoV‐19 is rare in Asia

Azd-1222

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