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A rare case of vaccine-induced immune thrombosis and thrombocytopenia and approach to management.
Kotal, Raghavendra; Jacob, Ipe; Rangappa, Pradeep; Rao, Karthik; Hosurkar, Guruprasad; Anumula, Satish Kumar; Kuberappa, Avinasha M.
  • Kotal R; Department of Intensive Care, Columbia Asia Hospital, Bengaluru, Karnataka, India.
  • Jacob I; Department of Intensive Care, Columbia Asia Hospital, Bengaluru, Karnataka, India.
  • Rangappa P; Department of Intensive Care, Columbia Asia Hospital, Bengaluru, Karnataka, India.
  • Rao K; Department of Intensive Care, Columbia Asia Hospital, Bengaluru, Karnataka, India.
  • Hosurkar G; Department of Neurology, Columbia Asia Hospital, Bengaluru, Karnataka, India.
  • Anumula SK; Department of Haematology Columbia Asia Hospital, Bengaluru, Karnataka, India.
  • Kuberappa AM; Department of Neurosurgery, Columbia Asia Hospital, Bengaluru, Karnataka, India.
Surg Neurol Int ; 12: 408, 2021.
Article in English | MEDLINE | ID: covidwho-1368105
ABSTRACT

BACKGROUND:

The use of the COVID-19 vaccines Vaxzevria from AstraZeneca and Covishield from Janssen has been associated with sporadic reports of thrombosis with thrombocytopenia, a complication referred to as vaccine-induced immune thrombotic thrombocytopenia (VITT) or vaccine-induced prothrombotic immune thrombocytopenia. It presents commonly as cerebral sinus venous thrombosis (CSVT), within 4-30 days of vaccination. Females under 55 years of age are considered to be especially at high risk. Mortality up to 50% has been reported in some countries. Identification of early warning signs and symptoms with prompt medical intervention is crucial. CASE DESCRIPTION We report here a case of VITT in a young female who presented 11 days after receiving the first dose of the Covishield vaccine, with severe headache and hemiparesis. She was diagnosed with CSVT with a large intraparenchymal bleed, requiring decompressive craniectomy and extended period on mechanical ventilation.

CONCLUSION:

The patient was successfully treated with intravenous immunoglobulin and discharged after 19 days in ICU. Although she was left with long-term neurological deficits, an early presentation and a multidisciplinary approach to management contributed toward a relatively short stay in hospital and avoided mortality.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Topics: Long Covid / Vaccines Language: English Journal: Surg Neurol Int Year: 2021 Document Type: Article Affiliation country: SNI_689_2021

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Prognostic study Topics: Long Covid / Vaccines Language: English Journal: Surg Neurol Int Year: 2021 Document Type: Article Affiliation country: SNI_689_2021