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Therapeutic plasma exchange (TPE) as a plausible rescue therapy in severe vaccine-induced immune thrombotic thrombocytopenia.
Rock, Gail; Weber, Viktoria; Stegmayr, Bernd.
  • Rock G; Canadian Apheresis Group, Ottawa, Canada. Electronic address: cag@cagcanada.ca.
  • Weber V; Department for Biomedical Research, Center for Biomedical Technology, Danube University, Krems, Austria. Electronic address: Viktoria.Weber@donau-uni.ac.at.
  • Stegmayr B; Department of Public Health and Clinical Medicine, Faculty of Medicine, Umea University, Umea, Sweden. Electronic address: bernd.stegmayr@medicin.umu.se.
Transfus Apher Sci ; 60(4): 103174, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1251570
ABSTRACT
Vaccine-induced immune thrombotic thrombocytopenia (VITT) is associated with high titers of immunoglobulin G class antibodies directed against the cationic platelet chemokine platelet factor 4 (PF4). These antibodies activate platelets via FcγIIa receptors. VITT closely resembles heparin-induced thrombocytopenia. Inflammation and tissue trauma substantially increase the risk for forming pathogenic PF4 antibodies. We therefore propose the use of therapeutic plasma exchange as rescue therapy in VITT to deplete antibodies plus factors promoting inflammation such as excess cytokines in the circulation as well as extracellular vesicles derived from activated platelets.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Plasma Exchange / Purpura, Thrombotic Thrombocytopenic / Platelet Factor 4 / Salvage Therapy / COVID-19 Vaccines Type of study: Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Transfus Apher Sci Journal subject: Hematology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Plasma Exchange / Purpura, Thrombotic Thrombocytopenic / Platelet Factor 4 / Salvage Therapy / COVID-19 Vaccines Type of study: Prognostic study Topics: Vaccines Limits: Humans Language: English Journal: Transfus Apher Sci Journal subject: Hematology Year: 2021 Document Type: Article