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Deterioration of vaccine-induced immune thrombotic thrombocytopenia treated by heparin and platelet transfusion: Insight from functional cytometry and serotonin release assay.
Bérezné, Alice; Bougon, David; Blanc-Jouvan, Florence; Gendron, Nicolas; Janssen, Cecile; Muller, Michel; Bertil, Sébastien; Desvard, Florence; Presot, Isabelle; Terrier, Benjamin; Chocron, Richard; Sanchez, Olivier; Helley, Dominique; Smadja, David M.
  • Bérezné A; Department of Internal Medicine and Infectious Diseases CHR Annecy-Genevois Annecy France.
  • Bougon D; Department of Intensive Care CHR Annecy-Genevois Annecy France.
  • Blanc-Jouvan F; Department of Clinical Biology CHR Annecy-Genevois Annecy France.
  • Gendron N; Hematology Department Université de Paris Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP) Paris France.
  • Janssen C; Université de Paris Innovative Therapies in Hemostasis INSERM Paris France.
  • Muller M; Biosurgical Research Lab (Carpentier Foundation) Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP) Paris France.
  • Bertil S; Department of Internal Medicine and Infectious Diseases CHR Annecy-Genevois Annecy France.
  • Desvard F; Department of Intensive Care CHR Annecy-Genevois Annecy France.
  • Presot I; Hematology Department Université de Paris Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP) Paris France.
  • Terrier B; Hematology Department Université de Paris Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP) Paris France.
  • Chocron R; Hematology Department Université de Paris Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP) Paris France.
  • Sanchez O; Université de Paris PARCC INSERM Paris France.
  • Helley D; Internal Medicine Department Université de Paris Assistance Publique Hôpitaux de Paris-Centre (AP-HP.CUP) Paris France.
  • Smadja DM; Université de Paris PARCC INSERM Paris France.
Res Pract Thromb Haemost ; 5(6): e12572, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1384307
ABSTRACT
We report a case of a 62-year-old man who developed cerebral venous sinus thrombosis with subarachnoid hemorrhage and concomitant thrombocytopenia, which occurred 13 days after ChAdOx1 nCov-19 injection. The patient died in the intensive care unit after heparin infusion and platelet transfusion. The key clinical purpose of this case report is to better understand how to confirm vaccine-induced immune thrombotic thrombocytopenia (VITT). VITT diagnosis was made using 14C-serotonin release and flow cytometry evaluating activation and platelet microvesicles on washed platelets. Four control patients were examined a patient with heparin-induced thrombocytopenia (HIT), two patients with thrombotic events without thrombocytopenia after ChAdOx1 nCov-19 or BNT162b2, and a patient with suspected HIT and an excluded diagnosis. We evidenced in the VITT case a high level of IgG anti-platelet factor 4-heparin antibodies associated with a high level of platelet activation in the absence of heparin. Conversely, the functional assays were negative in the patients with thrombosis without thrombocytopenia.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study Topics: Vaccines Language: English Journal: Res Pract Thromb Haemost Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Observational study Topics: Vaccines Language: English Journal: Res Pract Thromb Haemost Year: 2021 Document Type: Article